Caries is the most prevalent disease of children and is epidemic in some populations. A risk-based approach to managing caries targets those in greatest jeopardy for contracting the disease, as well as provides evidence-based decisions to treat current disease and control it in the future. This paper outlines key concepts necessary to effectively manage and reduce caries based on the most current science to date. Subsequent articles will outline a roadmap to success in curing dental caries.