This investigation was undertaken to compare occlusal disharmonies in the primary dentition of 332 pre-school children in a high fluoride area with those of 332 children in a low fluoride area of Turkey. The study populations consisted of 159 girls and 173 boys, ages 3-6, living in high-fluoride Isparta (mean 2.16 ppm IF in the drinking water) along with 161 girls and 171 boys of the same ages living in lowfluoride Erzurum (0.04 ppm F). The percentages (in parentheses) of the various occlusal disharmonies for the high versus the low fluoride areas were: deep overbite (10.5 vs 9.1), excessive overjet (9.04 vs 9.6), anterior crossbite (7.5 vs 1.6), anterior openbite (3.9 vs 7.8), posterior crossbite (2.1 vs 1.5), and anterior crowding (0.6 vs 3.3). Three of these six differences are statistically significant. In the high fluoride area, anterior crossbite was significantly higher (p < 0.001), whereas anterior openbite and anterior crowding were significantly lower (p < 0.05) in the high fluoride area compared to the low fluoride area. No significant gender differences were found.