Objective To investigate whether early or regular preventive dental visit (PDV) reduces restorative or emergency dental care and costs for low‐income children. Study Setting Enrollees during 1998–2012 in the Alabama CHIP program, ALL Kids. Study Design Retrospective cohort study using claims data for children continuously enrolled in ALL Kids for at least 4 years. Analyses are conducted separately for children 0–4 years, 4–9 years, and >9 years. For 0–4 years, the intervention of interest is whether they have at least one PDV before age 3. For the other two age groups, interventions of interest are if they have regular PDVs during each of the first 3 years, and if they have claims for a sealant in the first 3 years. Outcomes—namely restorative and emergency dental service and costs—are measured in the fourth year. To account for selection into PDV, a high‐dimensional propensity scores approach is utilized. Data Extraction Claims data were obtained from ALL Kids. Principal Findings Only sealants are associated with a reduced likelihood of using restorative and emergency services and costs. Conclusions Whether PDVs without sealants actually reduce restorative/emergency pediatric dental services is questionable. Further research into benefits of PDV is needed.