The epidemiology of dental caries in the pediatric population demonstrates that caries is no longer pandemic in the US population. The incidence is confined to a subset of the total population of our children. The disease is also increasingly isolated to specific teeth and tooth morphology types in both the pediatric and the mixed dentitions, with pits and fissures being the predominate diseased sites. This sequestration of the disease into specific populations, individuals and tooth sites mandates a risk assessment strategy. In the past, universal preventive strategies were appropriate because of the extensive penetration of caries in the population. Our health care system does not have adequate resources to treat the entire population when a substantial portion of the population is not at risk for this disease process. Validated risk assessment strategies may prove adjunctive for the practicing dentist. Certainly knowledge of the known risk factors will assist the practitioner in performing risk assessment within their patient populations. This paper presents a review of the known risk factors for dental caries in child and adolescent populations.