Objectives <p>Caries is still one of the most common diseases in Germany and world-wide, and most adults, children and adolescents are affected during their lifetime. The primary goal of oral disease prevention is therefore maintaining healthy teeth that are either free from decay or sufficiently restored without any secondary caries.</p> Materials and methods <p>This updated S3-guideline is intended to provide scientifically sound information on basic measures and recommendations for caries prevention in the permanent dentition, based on the current state of knowledge on etiology and pathogenesis of caries. This guideline applies to all persons with permanent dentition, provides information for dentists, educators, teachers, parents and other multipliers. Its core messages can be divided into measures to be taken by the population at home, and measures recommended and carried out by staff members in dental practices.</p> Results <p>The classic caries prevention pillars (tooth brushing, fluoride use, nutritional advice and regular dental consultations) have been expanded to seven recommendations: (I) Oral hygiene, including interdental cleaning; (II) Risk-adapted recommendations for fluoride use as part of daily oral hygiene, plus use of fluoridated table salt; (III) Reducing sugar consumption. In addition, in dental practices (IV) the participation in risk-adapted and structured prevention programs should be recommended, (V) application of further highly concentrated fluoride preparations such as varnishes, (VI) application of chlorhexidine in case of orthodontic treatment or exposed root surfaces, and (VII) fissure sealing in areas at high risk of caries development should be considered.</p> Conclusions <p>These measures can help promote lifelong dental health.</p> Clinical relevance <p>The recommendations of the guideline should be implemented in individual and professional caries prevention.</p>