This lecture provides an overview of the latest concepts in caries prevention based on 2019-2020 published research, and lays out a new conceptual framework for sustaining oral health across the lifespan, for caries prevention. Synbiotics, probiotics and prebiotics will be discussed, as well as other novel strategies for altering the dental plaque biofilm, and how these are applied to special risk situations such as young children and teenage orthodontic patients.