The oral condition is often overlooked and underappreciated as a crucial health risk factor, despite the fact that oral problems can have far-reaching effects on overall health and well-being. Dental caries (tooth decay) is the number 1 chronic condition among US children and is 5 times more prevalent than childhood asthma. However, oral healthcare is still the most common unmet healthcare need among children. Diet is the primary etiologic factor in the caries process. Unfortunately, the usual exhortation to “avoid sugar” or “avoid sweets” is meaningless because the dietary factors involved in the caries process are more complex than simply encompassing the general category of sweets. Thus, dietary guidelines must be provided to pediatric populations if dental caries is to be prevented. This article reviews the factors involved in dental caries—especially the dietary factors—in young children and provides strategies for preventing this serious disease.