Purpose: The paper examines African immigrant parents' views on dental decay and whether such views affect their decision to obtain dental insurance for their children. The paper also examines the cultural underpinnings of the immigrants' oral health care practices. Design/methodology/approach: The data for the study were collected in the states of Indiana and Virginia. The data were collected in 2005 by the author and a research assistant. A total of 420 parents (220 males and 200 females) took part in the research, answering questions about 601 children. Findings: The results indicate that a sizeable number of African immigrant school-aged children are denied dental health due to a combination of cultural perceptions on dental health (such as families taking responsibility for cleaning their teeth themselves), parental ignorance on dental health, parents' perception of dental health practice in the USA, and the parents' weak financial standing. Originality/value: The study is of considerable importance to dental care providers, public health specialists, social workers, and more especially the school systems that have African immigrant children, because as people who provide information and guidance to such immigrants, knowing about how the immigrants' cultural backgrounds influence their decisions about dental care will help to serve the immigrants more effectively. (Contains 3 tables and 1 figure.)