Dental caries is a complex disease affecting many adults. Although caries preventive efforts have historically focused on children, there are many issues that place some adults at greater risk for caries lesions. Identifying risk factors and creating a management protocol for each patient is key to a successful outcome. This quality Resource Guide (QRG), using an evidence-based approach, will discuss contemporary management of dental caries in adults, including: determining caries risk status\; detecting caries lesions at an earlier stage and assessing their activity status\; making a diagnosis of whether the disease is actually present\; establishing a prognosis\; applying intervention strategies focused on preventing, arresting and possibly reversing the caries process\; and restricting restorative treatment to only when absolutely necessary. The QRG will outline the 4D approach (a Caries Management by Risk Assessment [CAMBRA] System) designed to personalize caries management with the goal of maintaining health and preserving tooth structure. The QRG is an important reference for the dental clinician assessing an adult with active dental caries. It also provides background information for the dental office team to answer a patient&rsquo\;s questions regarding the reasons why he/she may have increased caries activity, and the therapy options that are available.