Across all medical disciplines, therapeutic interventions are based on previously acquired diagnostic information. In cariology, which includes the detection and assessment of the disease "caries" and its lesions, as well as non-invasive to invasive treatment and caries prevention, visual inspection and radiology are routinely used as diagnostic tools. However, the specificity and sensitivity of these standard methods are still unsatisfactory and the detection of defects is often afflicted with a time delay. Numerous novel methods have been developed to improve the unsatisfactory diagnostic possibilities in this specialized medical field. These newer techniques have not yet found widespread acceptance in clinical practice, which might be explained by the generated numerical or color-coded output data that are not self-explanatory. With optical coherence tomography (OCT), an innovative image-based technique has become available that has considerable potential in supporting the routine assessment of teeth in the future. The received cross-sectional images are easy to interpret and can be processed. In recent years, numerous applications of OCT have been evaluated in cariology beginning with the diagnosis of different defects up to restoration assessment and their monitoring, or the visualization of individual treatment steps. Based on selected examples, this overview outlines the possibilities and limitations of this technique in cariology and restorative dentistry, which pertain to the most clinical relevant fields of dentistry.