Dental caries is an infectious, communicable disease, which causes destruction of teeth by acid-forming bacteria found in dental plaque. Caries progression or reversal is determined by the balance between protective and pathological factors in the mouth. There have been revolutions in every field and dentistry is no exception to it, these changes have led to a change in concept from the conventional surgical approach of removing dental decay and cutting of tooth structure to the medical model which deals with interception of disease at different stages and possible reversal of the disease process. The key to medical paradigm is determination of caries risk in an individual and effective early detection of initial carious lesions. There are various equipments available in market which uses different principles for diagnosing caries susceptibility in an individual. In the years of thorough research different agents have been investigated for their role in caries prevention and reversal. There is a separate treatment plan for managing patients falling in different risk category. This article outlines the need for the medical management of dental caries and how it can be a viable option in dental decay management.