Dental caries is a process that typically keeps recurring throughout life, and the consequences are too often seen as irreversible damage to the dentition. At various stages of life, different parts of the dentition are affected, and the effects continue to be seen in the dentition long after the events took place. They bear witness to previous occurrences of this process throughout the lifetime of an individual. This chapter reviews the linkage between the caries process and the dental caries lesion history of the human dentition. The prevalence and distribution of the caries burden are very variable and closely tied to cultural aspects. In the primary dentition, income and education have been found to be inversely associated with: (1) any early childhood caries and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. These patterns are different from those of the permanent dentition. Well-documented changes in caries prevalence have been observed throughout history, most closely tied to availability and amount of refined sugar consumed. Changes in caries rates are also well documented in the 20th century, mainly with the advent of fluoride in several forms, first as a steep decline and recently as being relatively unchanged. It is likely that there will be dramatic changes in the rates and distribution of dental caries in the future, due to changes in behavioural factors and therapeutic measures. The description drawn is based on the dental caries pattern experienced in modern western societies.