This review is limited to an analysis of the relationship of the consumption of sugar to the prevalence of caries in man. The data reveal that in the human a highly forged link exists between these variables. In the absence of sugar, little decay is found; when used in large amounts over protracted periods of time, caries scores are usually high. The evidence also suggests that it is possible to reduce the incidence of caries by reducing the intake of refined sugars. Conflicting evidence exists in man, however, with regard to the influence of the total intake of sugar, the form in which it is consumed and the frequency of its consumption on the prevalence of dental decay. Moreover, little is known about the amount of sugar that individuals actually consume each day. Cause and effect conclusions should not be limited to one or another type of study. In the aggregate, the results obtained from studies in vitro, investigations in experimental animals, as well as studies in humans, all point to the existence of a powerful sugar-caries axis. More research on human subjects is needed, however, to fill the gaps in our knowledge.