Caries management could provide a unique opportunity to model reform to the dental reimbursement system. To be successful we must first understand the scope and basis of many of the obstacles to reform. Reform must also provide value to all the players involved in benefit determination, provision of care, and payment for care. Value is viewed as outcomes achieved per dollar from the patient's perspective and over a complete cycle of care or management. Reimbursing for value requires measurement of value, and one hypothetical model for caries management is presented based on Michael Porter's hierarchy of outcome measures.