The traditional restorative approach to active dentin caries in the temporary dentition is questioned. This paper argues in favour of a causal approach. The causal approach focuses on caries management. Restoration is of secondary importance. Delay or replacement of invasive restorative treatment by a causal approach decreases discomfort for children and promotes oral health over time. A form of causal treatment is the so called ‘Non-Restorative Cavity Treatment’. This approach requires that some measures be taken for managing cavitated caries lesions: 1. written informed consent; 2. making the cavity accessible for plaque removal; 3. treating carious dentition with anti-cariogenic agents and/or applying a protective layer to the carious dentition; 4. monitoring the caries process; 5. effective communication about dental health education. Some diagnostic criteria are important for the risk assessment of cavitated lesions: 1. activity of the caries lesion; 2. accessibility of the caries lesion for plaque control; 3. depth of the cavity; 4. condition of the pulp. Conclusion: the causal approach can arrest the caries process even in advanced stages of decay.