Purpose: The aim of the study was to investigate whether caries-active and caries-free children differ in terms of their taste perception for sweet, sour, salty and bitter. Methods: The study group consisted of 100 children aged 5–10 years: 50 caries-free children and 50 children with at least four untreated carious lesions. Taste perception was analysed using two test systems. First, filter paper strips impregnated with four taste qualities (sweet, sour, salty, and bitter) at four defined intensities were used (“taste strips”). Then a tasting spray in suprathreshold concentration of the respective taste was applied. The children were asked to name the perceived taste. The parents answered a questionnaire about the children’s dietary habits. Results: The children with high caries activity scored lower on average on the taste strips than the caries-free participants. For the taste sprays, the perception of the taste quality “bitter” was significantly worse in the children with caries than in caries-free children (Mann–Whitney U test p < 0.05). Conclusion: The results of this study suggest that taste preferences in children are associated with increased susceptibility to tooth decay.