Objective: This study aimed to determine the relationship between enamel developmental defects (DDEs) and children’s oral symptoms in the early and late mixed dentition in a hierarchical approach. Methods: Population-based cross-sectional study of 772 children. Calibrated dental examiners examined for DDEs, malocclusion, and dental caries. Parents answered questions related to the socioeconomic condition of the family. The Child Perception Questionnaire (CPQ8-10) was used to identify oral symptoms as the outcome variable. Analysis was adjusted in a backward stepwise hierarchical multiple logistic regression model. Results: Symptoms were predicted by being female, having a father with low education and having DDEs in the upper first molars (ORs = 1.42; 95% CI: 1.06-1.89; 1.46: 1.10-1.96 and 2.02: 0.99-4.05 respectively). Conclusion: DDEs are associated with oral symptoms in Brazilian children. Keywords: children, enamel developmental defects, oral symptoms.