Background: The human oral cavity harbors a diverse array of microbial species, with around 700 to 1000 species residing in the mouth. Oral diseases such as dental caries, periodontal disease, and oral cancer are closely linked to these oral microorganisms. The economic burden of dental diseases is substantial, with direct and indirect costs estimated in billions of dollars. Dental caries, a biofilm-associated disease, is a prevalent global issue affecting a large percentage of the population, particularly children and adults. Prevention of caries is crucial in public health management, with a shift towards early detection and monitoring to preserve tooth structure and promote natural healing processes. Objective: This research aims to investigate the specific microbial species responsible for causing dental caries, explore their mechanisms in caries development, evaluate the effectiveness of current preventive measures like fluoride treatments, and identify new strategies targeting microbial etiologies for caries prevention. Conclusion: Dental caries remains a significant global public health concern, with microbial biofilms playing a crucial role in its etiology. While conventional preventive measures like fluoride treatments and dental hygiene practices have shown some efficacy, there is a growing interest in natural antimicrobial compounds from plants as potential alternatives for caries prevention. Incorporating microbiologically-based strategies and emphasizing prevention over treatment could lead to more successful outcomes in managing dental caries. Further research into the mechanisms of action of anti-caries compounds and optimal dosing schedules for fluoride treatments is essential to enhance preventive strategies against dental caries.