This review investigates the mechanisms of bioactive glass on the management of dental caries. Four databases (PubMed, Web of Science, EMBASE (via Ovid), Medline (via Ovid)) were systematically searched using broad keywords and terms to identify the literature pertaining to the management of dental caries using “bioactive glass”. Titles and abstracts were scrutinized to determine the need for full-text screening. Data were extracted from the included articles regarding the mechanisms of bioactive glass on dental caries management, including the aspect of remineralizing effect on enamel and dentine caries, and antimicrobial effect on cariogenic bacteria. After removal of duplicates, 1992 articles were identified for screening of the titles and abstracts. The full texts of 49 publications were scrutinized and 23 were finally included in this review. Four articles focused on the antimicrobial effect of bioactive glass. Twelve papers discussed the effect of bioactive glass on demineralized enamel, while 9 articles investigated the effect of bioactive glass on demineralized dentine. In conclusion, bioactive glass can remineralize caries and form apatite on the surface of enamel and dentine. In addition, bioactive glass has an antibacterial effect on cariogenic bacteria of which may help to prevent and arrest dental caries.