Early enamel caries is characterized by mineral loss beneath a relatively intact surface. Because mature enamel lacks ameloblasts and endogenous regenerative capacity, therapeutic goals should extend beyond surface mineral deposition to subsurface mineral recovery, restoration of crystal orientation and hierarchical organization, and durable mechanical function. Recent strategies based on calcium-phosphate ionic or pre-nucleation clusters, amorphous calcium phosphate precursors, amelogenin-derived peptides, and other organic templates have improved precursor stabilization and the regulation of ordered crystallization. Tooth-surface functionalization, wet adhesion, pH-responsive release, and targeted antimicrobial systems are also promoting a transition from the simple combination of anticaries and remineralizing functions toward their spatial and temporal coordination. Nevertheless, most available evidence has been obtained from simplified in vitro demineralization or monospecies biofilm models, while repair remains largely confined to micrometer-scale surface layers. Robust evidence is still lacking for mineral recovery throughout clinically representative subsurface lesions, reconstruction of enamel rod/interrod architecture and interfacial continuity, and resistance to recurrent acid challenge, wear, and fatigue. Nonselective antimicrobial interventions may additionally disrupt oral microbial ecology. This expert perspective summarizes advances in surface mineral deposition, subsurface repair, structural and functional reconstruction, and antimicrobial and ecological regulation, while examining the major barriers to clinical translation. Future studies should employ clinically relevant subsurface caries lesions and multispecies biofilm models, integrate lesion-responsive activation and durable material retention with selective virulence control, and establish an evaluation framework linking mineralization depth, structural continuity, and long-term function. The central objective of enamel caries prevention and remineralization is to restore mineral within deep subsurface lesions and rebuild an enamel-continuous, hierarchically organized, and durable structure without compromising oral microbial homeostasis.