Risk assessment is an essential component in decision-making for the prevention and management of caries. Systematic reviews have provided evidence that past caries experience is the single best predictor for future caries development in schoolchildren and adolescents and that the usefulness of additional risk factors is questionable. In preschool children however, prediction models which include multiple risk factors seem to increase the predictive accuracy. Thus, data on family income, daily care and health beliefs, mutans streptococci counts, dietary habits and inadequate exposure to fluoride must be considered for a comprehensive risk assessment in toddlers and preschool children. Computerized tools do not increase accuracy per se but may be of didactic use for motivation of parents.