OBJECTIVES: The purpose of this study was to analyze the pattern of dental caries in a high-risk group of Korean adolescents. METHODS: Raw data on 10,542 adolescents between the ages of 12 and 15 years from the 2012 Korean National Oral Health Survey was used. The subjects were divided into a high caries risk group and non-high caries risk group for analysis. For the statistical analyses, we utilized a frequency analysis, descriptive statistics, and a multidimensional scaling analysis. RESULTS: The pattern of dental caries in the high caries risk group were divided into six classifications for 12-year-olds and five for 15-year-olds, including the mandibular first molar occlusal surface (Cluster 1). In the high caries risk group, the frequency of Cluster 1 was approximately 4-times higher in 12-year-olds than that in the non-high caries risk group of Cluster 1, and about 3-times higher in 15-year-olds. The multidimensional scaling analysis found that in the high caries risk group, the same types of tooth surfaces formed separate groups. The prevalent dental caries pattern of 12-year-olds in the high caries risk group was left-right symmetry, while in the 15-year-olds of the high caries risk group, the caries pattern also included the antagonistic teeth, along with left-right symmetry. However, the non-high caries risk group had a pattern of left-right symmetry only in the 15-year-olds. CONCLUSIONS: When dental caries occur in the first molar, there is a high possibility of being classified into the high caries risk group. Therefore, preventative measures should focus on the antagonistic teeth and the teeth on the opposite side.