Objective <p>Dental caries (DC), a&#xa0;biofilm-mediated permanent disease, affects approximately 50% of the global population. Diet is an important modifiable factor among many factors affecting DC. At present, the health benefits of foodborne microbe intake are widely recognized. We aimed to study the association of dietary active microbe intake with the occurrence of DC among American adults.</p> Materials and methods <p>Data of adults with complete clinical information were extracted from the National Health and Nutrition Examination Surveys (NHANES) 2015–2020. Occurrence of untreated DC was the primary outcome and DC experience was the secondary outcome. Dietary active microbe intake was divided into three groups: G1 (low), G2 (medium), and G3 (high). Logistics models were performed to test the association of dietary DC with untreated DC and DC experience. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Further subgroup analyses were performed to verify whether the association between them remained robust.</p> Results <p>A total of 12,762 subjects were included; among them, 3458 (27.10%) had untreated DC. After adjusting all covariates, we observed subjects with G2 and G3 levels of dietary active microbe intake had lower occurrence of untreated DC (G2, OR = 0.81, 95%CI 0.69–0.94; G3, OR = 0.72, 95%CI 0.61–0.84). Subjects with G3 level of dietary active microbe intake were linked to a&#xa0;lower incidence of DC experience (OR = 0.72, 95%CI 0.55–0.94). Subgroup analysis suggested a&#xa0;robust association of dietary active microbe intake and untreated DC and DC experience.</p> Conclusion <p>Our study suggested the potential advantage of high levels of dietary active microbe intake for the prevention of DC in American adults.</p>