This review explores the multifactorial etiology of dental caries disease. Current theories suggest that a singular focus on mutans streptococci and lactobacillus as the sole causative microbiological agents is no longer a viable strategy in treatment of this prevalent disease. Dental caries is an infectious transmissible disease process where a cariogenic biofilm in the presence of an oral status that is more pathological than protective leads to the demineralization of dental hard tissue.