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Aim Determine the risk indicators of caries lesion activity in a child sample from Porto Alegre, Brazil. Materials and methods Study design: cross-sectional study included 97 individuals aged between 3 and 12-years who sought treatment at the Paediatric Clinic at the Dental Teaching Hospital at the Federal University of Rio Grande do Sul, between 2017 and 2018. Questionnaires recorded sociodemographic data, frequency of sugar intake, and toothbrushing frequency. Clinical examination included the visible plaque index, gingival blood index, and caries lesion activity.

Results The mean of surfaces with active caries lesions was 9.81 (IC 95%= 8.47–11.15). Children who presented a frequency of sugar intake of twice/day (PR= 1.62, IC 95%= 1.30–2.03), three times/day (PR= 1.68, IC 95%= 1.37–2.08), and four or more times/day (PR= 1.59, IC 95%= 1.26–2.01), were likely to have active lesions. Ages between 8 and 12-years were associated with a lower probability of active carious lesions (PR= 0.77, IC 95%= 0.66–088). Statistics: Poisson regression analysis was used to estimate the child’s relative risk of developing new active caries lesions. Conclusions The monitoring of sugar intake should be considered a strong instrument for the strategies of control of dental caries in children.