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Dental caries remains one of the most prevalent chronic diseases worldwide, affecting individuals across all age groups despite substantial advances in preventive dentistry. Contemporary understanding recognizes dental caries as a dynamic, biofilm-mediated, diet-modulated disease that can be prevented, arrested, or reversed through timely risk assessment and evidence-based preventive interventions. This review synthesizes current evidence on modern strategies for caries prevention, emphasizing individualized caries risk assessment, fluoride-based therapies, pit and fissure sealants, dietary modification, biofilm control, remineralization technologies, and minimally invasive management approaches. Established risk assessment models, including Caries Management by Risk Assessment (CAMBRA), the International Caries Classification and Management System (ICCMS™), and other validated tools, are discussed in relation to personalized preventive care. Emerging technologies such as silver diamine fluoride, resin infiltration, bioactive restorative materials, artificial intelligence-assisted diagnostics, and digital caries detection are also evaluated for their clinical applications and future potential. Furthermore, preventive strategies across different stages of life are explored, highlighting age-specific approaches for children, adolescents, adults, older adults, and medically compromised individuals. Current international clinical guidelines consistently support a shift from the traditional restorative model toward prevention-focused, patient-centred, and minimally invasive dentistry. Integrating evidence-based preventive measures with individualized risk assessment enables clinicians to preserve tooth structure, improve long-term oral health outcomes, and reduce the global burden of dental caries. Continued research into precision dentistry, salivary diagnostics, and digital technologies is expected to further transform preventive dental care in the coming years.