Background: Training of pediatricians on early childhood caries (ECC) screening and referral during their medical pediatric practice has been suggested to promote childhood dental care. Objective: To assess the accuracy of pediatricians in detection of ECC and trauma and to estimate the rate of referral after  being trained by a pedodontist. Methods: The study was conducted atpediatric outpatient clinics of a governmental pediatric hospital in Alexandria, Egypt. Dental examination of 137 children- six to thirty six months of age was carried out independently by a pedodontist and pediatricians to identify cases of ECC and trauma after a training program for physicians about diagnosis of dental caries and referral needs. Results: Fifty dental conditions were detected among 33.6% of the children (46 children) with a rate of 36.5%. The rate of ECC among children was 27.7% with pre-cavitated caries as the most common type (16.1%). The mean age of children with ECC is significantly higher than that of children without ECC (t=3.23, p=0.002). The rate of dental trauma was 9%. The positive predictive value of pediatricians' detection of ECC was 100%, the sensitivity was 94.74%and the specificity was 100%. The children referred for dental care by pediatricians represented 88 % of those referred by the pedodontist. Conclusion: Pediatricians can achieve high accuracy of identification of cases with ECC and of cases in need for dental referral through inservice training.