Dental caries occurs due to demineralization of enamel and dentine by organic acids formed by bacteria in dental plaque through the anaerobic metabolism of sugars derived from the diet. Both the frequency of consumption and total amount of sugars is important in the etiology of caries. While the causal relationship between sucrose and dental caries development is indisputable, the relationship between food starch and dental caries continues to be debated. This chapter discusses available evidence of role of sugars in caries formation. It also includes a note on relationship between starchy foods and dental caries, protective dietary factors and non-sugar sweeteners.