There is a slow trend in caries improvement among school children in Malaysia. This study aimed to analyse the association between gender, ethnicity and location of residence with dental caries occurrence among the secondary school children receiving incremental dental care in Jempol, Negeri Sembilan. This 4-year retrospective cohort study consisted of all secondary school children in Jempol initially aged 13-year-old in 2013 who were treated under the School Dental Service. Bivariate logistic regression was performed to analyse the association between gender, ethnicity, and location of residence with dental caries occurrence. The sample consisted of 942 school children. Results showed a significant association between dental caries occurrence with gender and ethnicity. However, it was not significantly associated with location of residence. Females were 1.39 times more likely to develop new caries than males. Compared to the Indian ethnic group, the odds of developing new caries were 2.54 times higher for Malay (95% CI: 1.65-3.92) and 1.32 times higher for Chinese school children (95% CI: 0.77-2.26). The findings of this study can be used to identify the risk group early in life and tailored oral health services can be delivered according to their needs.