To review predisposing factors contributing to dental caries in patients with cleft lip, cleft palate, or both (CL/P). Patients with CL/P have a higher susceptibility to caries compared with the population group without clefts. A review of the literature was undertaken to determine factors that could account for the compromised oral hygiene and the high caries prevalence in patients with CL/P. After a literature review, modern strategies for the prevention of early childhood caries were developed and should be considered for integration into the overall management protocol of patients with CL/P. Preventive dental care is ever more so important in patients with CL/P compared with patients without clefts.