Abstract: Lactobacillus is the first microorganism found to be closely associated with dental caries. It demonstrates acidogenicity, aciduricity, and the ability to bind with collagen and to synthesize extracellular polysaccharides to promote bacterial adhesion. Some lactobacilli inhibit the growth of cariogenic bacteria by producing antibacterial compounds or metabolites, competing with cariogenic bacteria for adhesion sites or co-aggregation, or regulating the expression of genes related to cariogenic virulence. Therefore, researchers have, in recent years, experimented with applying Lactobacillus as probiotics in the prevention and control of caries. However, the cariogenic mechanism of Lactobacillus is still not fully understood, and the potential effects, presumably beneficial, of specific Lactobacillus on oral and intestinal microecology remain unknown. More research needs to be done to combine both the cariogenic and probiotic properties of Lactobacillus, and to comprehensively evaluate the effects of Lactobacillus on oral and systemic health. We, herein, summarized research progress in the cariogenicity and caries prevention effect of Lactobacillus, focusing on a discussion of the role of Lactobacillus in cariogenesis, the development of dental caries, and clinical prevention and control of dental caries, in order to provide new ideas and references for the prevention and control of dental caries.