Fluoride has played a crucial role in global oral health for over a century. It is widely available through various mediums, including drinking water, toothpaste, topical gels and professional treatments. Fluoride strengthens enamel by promoting remineralisation and inhibiting demineralisation. Despite its effectiveness in reducing the incidence of caries, its use can be contentious. This chapter examines the mechanisms of fluoride action, including systemic and topical sources and interactions with behaviours such as diet and smoking. It also evaluates the efficacy, safety and risks of fluoride use. Furthermore, global fluoride policies and interventions are explored and discussed. Dental professionals need to be knowledgeable about the evidence base for fluoridation and understand how to effectively communicate with patients and the public to address misconceptions and promote informed fluoride use. Ensuring equitable access to fluoride remains a public health priority, particularly in underserved populations where the burden of oral disease is the highest.