Dental caries remains one of the most prevalent chronic diseases worldwide, affecting individuals across all age groups. Fluoride therapy has been recognized as the most effective and evidence-based preventive strategy for reducing the incidence and progression of dental caries. Fluoride exerts its anticaries effects through enhancement of enamel remineralization, inhibition of demineralization, and suppression of cariogenic bacterial activity. Various fluoride delivery systems, including water fluoridation, fluoride toothpaste, mouth rinses, gels, varnishes, and professionally applied agents, have significantly improved oral health outcomes globally. This review examines the mechanisms of action, methods of fluoride delivery, clinical effectiveness, advantages, limitations, safety considerations, and future directions of fluoride therapy in caries prevention. Current evidence demonstrates that fluoride remains a cornerstone of preventive dentistry and public health initiatives. The study concludes that fluoride therapy continues to play a critical role in reducing caries prevalence and promoting long-term oral health.