In this study, we investigated the oral status of children suffering from end-stage renal disease (ESRD) with the aim of determining the causes of low caries prevalence in this population (using the CRT bacteria and buffer test), and compared results with a control group (n=38). In the study group, there were 38 children (aged 4-17 years) who were being treated in pediatric nephrology units at three different hospitals in Izmir, Turkey. The study and control groups did not significantly differ in daily tooth brushing frequency and periodic dental check-up frequency. Severe enamel hypoplasia was present in the study group. Dmft, DMFT, gingival and plaque indices were compared statistically in mixed dentition stage with the control group and dmft and gingival status showed a statistically significant difference (p<0.05). The differences among groups for DMFT and plaque indices were not statistically significant. In the study group, high salivary buffer capacity was found in 89.5% of patients. Salivary levels of cariogenic streptococcus mutans and lactobacilli in the study group were significantly lower than in the control group. In conclusion, probably due to increased concentrations of antibacterial chemicals such as urea in the saliva of children with ESRD, decreased levels of cariogenic microorganisms were detected. Therefore, although dental treatment need is not high, these children should receive dental health education, including oral hygiene instruction, in order to improve their overall oral health.