The past seventy-five years have witnessed an extraordinary growth of scientific knowledge related to oral health and the development of evidence-based dentistry. The centrality of prevention to the control of oral diseases and the maintenance of good oral health has become increasingly recognized by the scientific community, dental educators, dental practitioners, and the public at large. Yet, despite significant improvements in the overall oral health of Americans, important disparities exist, and large segments of the population are disproportionately burdened by oral diseases. Despite the proven effectiveness of various preventive modalities, such as fluoridation and dental sealants, these have not been universally disseminated and implemented. This review will highlight the challenges remaining in completing the decades-long paradigm shift to prevention and the important role to be played by the dental education community in this process.