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ABSTRACTThe purpose of this epidemiological study was to determine the differences in the prevalence of caries between individuals with Down syndrome (DS) and their siblings. A sibling‐matched, population‐based and cross‐sectional survey was performed. This study involved 138 (62%) children with DS and 86 (38%) siblings, aged 2–26. The children were compared in different subgroups: [2, 6], [6, 12], and [13, 26]. Data was gathered through the use of a complete questionnaire and clinical observation. Data analysis was performed by using SPSS® v.18.0 software with any p value <.05 considered as significant. The DS group presented a significantly higher percentage of children within the caries‐free group: 72% versus 46% of the siblings group (p < .001). In the age gap [2, 6[the median value of DMFT was the same in both groups (p = .918). In the age gap [6, 12] the median value of DMFT in the DS group was 0 and in the siblings group was 1 (p = .004). In the age gap [13, 26] the median value of DMFT in the DS group was 0, whereas in the siblings group the median value was 3, which constitutes a significantly high difference (p = .003). The results of this study suggest that Portuguese children with DS have lower caries prevalence than their siblings.