Abstract: Objective: To explore the relationship between socioeconomic factors and the incidence of permanent tooth caries in school children. Methods: A baseline cohort of 946 seven-year-old children was recruited from Yulin City. A questionnaire was used to collect demographic, socioeconomic, oral health behavioral, and oral healthcare utilization data. Clinical oral examinations were performed, with follow-up assessments conducted every six months for 1 year. A generalized estimating equation(GEE) was employed to examine the association between socioeconomic factors and the 1-year incidence of permanent tooth caries in 7-year-old children. Results: At the one-year follow-up, 908 children were reassessed, yielding a follow-up rate of 96.0%. The incidence of caries in the first permanent molars increased over time, with the increment in decayed, missing, filled surfaces(△DMFS) rising from 310 to 485. The final GEE model indicated that children with low maternal education(95% CI=1.037-1.234, P=0.007), with fathers engaged in secondary or tertiary occupations(95% CI: 1.017-1.188, P=0.024; 95% CI: 1.109-1.401, P<0.001), and with lower per capita monthly household income(95% CI=1.003-1.152, P=0.044) had a higher risk of △DMFS increment in the first permanent molars. Conclusion: Low maternal education, paternal occupation status, and household income are significant risk factors for the incidence of permanent tooth caries in school children.