Preventive dental care for children and adolescents has historically focused on fluoride therapy, oral hygiene and home care maintenance, simple dietary advice, and the placement of fissure sealants. Traditionally, dental caries has been regarded as a static phenomenon, eventuating in loss of tooth structure while the basis for treatment and management of this ubiquitous disease has essentially been mechanical. However, with current developments in new dental materials, techniques and preventive strategies, a more precise understanding and appreciation of the nature of the caries process is required. The development of dental caries is a common yet complex series of dynamic events under the influence of numerous inter-related biological, social, behavioural and psychological factors. It is now increasingly recognized that certain 'high risk' caries-susceptible individuals persist within our communities for whom preventive measures and restorative care alone are not enough to control the disease. This paper will discuss and outline current preventive concepts, individual risk factors, and dietary considerations which can be utilized in a contemporary approach to caries risk assessment.