Dental caries is the world’s most common non-communicable disease with a complex etiology including social, behavioral, medical, biological and economical elements. The distribution among populations and age groups is skewed, which calls for validated clinical tools to identify those with increased caries risk. The aim of this article was therefore to review risk factors for caries development in children, based on global prospective birth cohorts, genetic proceedings and data from validated risk assessment tools. The genetic elements involve four main categories comprising enamel quality, salivary composition, dental biofilm function and taste preferences. Recent studies suggest that genes may account for 35–55% of the variation in caries scores in the young permanent dentition. Prospective birth cohorts have pointed out poverty, socioeconomic level, early introduction and excessive sugar intake as significant factors for a child’s dental caries trajectory up into adulthood. Moreover, prolonged breastfeeding, child obesity and maternal oral conditions are linked to the caries burden later in life. In the clinic, the strongest predictors are past caries history and selected behavio
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