Objective: Caries management by risk assessment (CAMBRA) is an integral component of dental caries management. The aim of this study was to evaluate caries management in 3–6-year-old children with high caries risk. Study design: Forty children aged 3–6 years who were at high risk for dental caries were selected. Dental plaque was assessed using Silness and Loe plaque index. Dental caries were recorded using def index and International caries detection and assessment system II (ICDAS II). Plaque levels of mutans streptococci (MS) and resting salivary pH was assessed. All the children received oral prophylaxis, sealants, restorations, and motivational interviewing (MI). The children were divided into two groups, group I and group II of 20 children each. Only group II received fluoride varnish application and a remineralizing toothpaste. All the children were examined for dental plaque and caries at 3-month intervals. At the end of 1 year, plaque levels of MS and resting salivary pH were assessed. Ten children from each group were randomly evaluated caries progression. Data were statistically analyzed. The level of significance was 5%. Results: Mean deft of group I increased from 4.2 to 4.45, which was significantly higher than 3.35 of group II (p = 0.04). In group I, the number of non-cavitated lesions was higher, and there was a significant difference in the number of cavitated lesions (p = 0.04). Mean dental plaque scores showed a significant reduction in group II (p < 0.05). In both groups, there was a significant increase in salivary pH (p < 0.05) and a significant reduction in plaque MS levels (p < 0.05). Conclusion: The use of fluoride varnish and remineralization using casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) proved to be effective in the caries prevention for high risk children.