In its early stages the carious process can still be arrested by preventive treatment. In today’s dentistry individual risk assessment becomes more and more important in order to provide the proper preventive treatments to high risk children. Diagnosis of caries implies more than just detection of lesions. The whole objective of caries management is to assess whether caries is progressing and if it is, attempts to arrest lesions should be made. This can be done by plaque control, modifying the diet, and use of fluoride. In fact it is the parent and the child who, each day, are in charge of the preventive management. This makes communication and behaviour modification a critical part of the work. With an early diagnosis more time will be available to tip the balance of the caries process towards delayed progression and lesion arrest.