Modern approaches to dental caries such as STEM (System for Total Environmental Management) are based on a whole-of-patient and whole-of-biofilm approach to the disease. There are now multiple lines of evidence which indicate that dental caries is a multi-pathogen disease and that mutans streptococci may participate but are not critically essential for disease to occur. A number of new strategies for controlling caries risk are currently being explored, based on the modern biofilm concept. Clinical diagnostic kits examine plaque or saliva for features of the biofilm which are surrogates (markers) of the disease process can be useful in clinical patient management since these can be undertaken at chairside
