OBJECTIVES: The aim of this study was to explore adolescents with high and no caries experience and their preferences for caries preventive dental care. Their willingness-to-pay (WTP) for preventive dental care was elicited using the contingent valuation method (CVM) within a cost-benefit approach. METHODS: Eighty-two individuals (19-year olds) agreed to participate in an exploratory case-control study. Thirty individuals with high caries experience formed the test group. The control group consisted of 52 individuals with no caries experience, selected randomly from a caries-free population. Using personal questionnaires in combination with the CVM, we elicited respondents' WTP for preventive dental care. The data were used to: (a) compare WTP between study groups, and (b) calculate net social benefit (NSB) in cost-benefit analysis (CBA). RESULTS: The result shows a mean yearly WTP for the high- and low-risk group of 1405 SEK and 1087 SEK (7.70 SEK = US$1; July 2005), respectively. Two variables were associated with the differences between the groups: caries risk (i.e. group designation) and housing. Using these WTP values, the CBA showed positive NSB values for both study groups. CONCLUSIONS: Through use of the CVM, 19-year olds' WTP for caries preventive measures was elicited. An NSB >0 was found, which means that benefits exceeded the costs for prevention. Despite the small sample size and restriction to one Swedish county, the results indicate that the methods used in this study are suitable for further testing and analyses.