Abstract: With the development of new dental restorative materials, advances in adhesive dentistry, better understanding of the caries process, the tooth’s potential for remineralization and changes in caries prevalence and progression; the management of dental caries has evolved from G.V. Black’s “extension for prevention” to “minimally invasive.” This concept includes early detection of lesions; individual caries risk assessment; nonsurgical interventions; and a modified surgical approach that includes smaller tooth preparations with modified cavity designs and adhesive dental materials to repair rather than replacement of failing restorations. The goal is preservation of natural tooth structure.