Management of dental caries as a disease requires the same level of skill and broad perspective as managing many other diseases. Dental caries has several variations, four of which were presented here. Long-term outlook for children with two of the caries patterns (those secondary to fissure defects or hypoplastic defects) is good if the teeth are restored. Management of children with nursing caries often involves dealing with well-intentioned but overindulgent parents. Prevention of nursing caries goes beyond simply informing the parents of potential dangers from excessive feeding with the bottle. Hypoplastic defects can resemble nursing caries; the differentiation is important in treating the child. The child with extensive proximal molar lesions may be the most difficult to manage on a long-term basis. A successful prevention program will mean a change in life style for the parent and child. The child with a cleft lip and/or palate has the disadvantages of enamel defects and a significant medical condition inviting overindulgence.