Decisions concerning use of fluoride in its many forms for caries prevention are more complicated now than in the past because of the need to balance these benefits with the risks of dental fluorosis. This article reviews pertinent literature concerning dental fluorosis (definition, appearance, prevalence), pre- and post-eruptive use of fluoride, esthetic perceptions of dental fluorosis, fluoride levels of beverages and foods, the Iowa Fluoride Study, and the U.S. Centers for Disease Control and Prevention's "Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States." Water fluoridation and use of fluoride dentifrice are the most efficient and cost-effective ways to prevent dental caries; other modalities should be targeted toward high-risk individuals.