Objectives: Provision of professional dental care is costly and unsustainable in remote Australia. We hypothesised that an annual “Big Bang” using known preventive interventions would be effective and potentially cost-effective. The objective here is to present the efficacy of the intervention differentiated by type of tooth surface. Methods: In 2015 and 2016 Fissure Sealants, Povidone Iodine and Fluoride Varnish were applied to consenting children in a remote Indigenous community in Far North Queensland. Those without consent constituted a natural control group. Clinical examination for dental caries at baseline (2015), one and two year follow-up, was conducted using ICDAS II which involves scoring each surface of all teeth for dental caries and restorations based on established criteria. Outcome was the cumulative number of surfaces with new caries (caries incidence) at one and two years follow-up in deciduous and permanent dentitions Results: 408 children participated at baseline while 141 (35%) and an additional 59, totalling 200 (49%) failed to attend at one and 2 years respectively. Caries incidence on occlusal surfaces was less in children receiving the intervention (1.12±1.41) than those without (2.05±2.09, p<0.0001) after one year. The intervention was also effective on smooth/proximal surfaces with lower caries incidence in the intervention group (3.27±4.23) than the control group. (4.96±5.34, p=0.005). Similarly, the intervention was effective after two annual applications at two years follow-up with lower caries incidence being observed on both occlusal (1.58±1.65 vs 2.35±2.27, p=0.008) and smooth+proximal surfaces (4.22±5.14 Vs 5.88±4.78, p=0.018) in intervention than the control group. Conclusions: Annual application of Fissure Sealants, where clinically indicated, then Povidone Iodine then Fluoride Varnish was equally effective in reducing caries incidence on occlusal and smooth+proximal surfaces at both one and two years follow-up. Annual preventive intervention is feasible, effective, and likely to be cost-effective for remote communities without resident oral health professionals.