Purpose: To assess the accuracy of two screening methods used by dentists in the Health Insurance Organisation in Alexandria, Egypt aiming at identifying children who need referral for treatment. Materials and Methods: The study included 45 dentists who examined 30 children using exclusively visual screening (VS) and visual screening with tongue blade (VSTB). A benchmark dentist examined the same group of children using mirror and probe (MP). VS and VSTB were compared to MP. Sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively) were calculated. The effect of dentist's gender, year of graduation and having postgraduate studies on the accuracy of the two methods was assessed. Results: VS had greater accuracy than VSTB. Both methods had a Sn and Sp >82%. The PPV of both methods was >97%, whereas that of NPV was ≤ 44%. Males and recent graduates performed better than females and senior dentists when using VS and VSTB methods. Conclusions: It is questionable whether screening using VS or VSTB can ensure effective referral of children for treatment. Further studies are needed to assess other aspects of screening, including whether referred children actually seek care and whether screening improves children's oral health. Keywords: accuracy, public health dentistry, school dental screening, visual examination