In Korea, fluoride was first introduced into the drinking water of residents of Jinhae, KyungNam in 1981 for the prevention of dental caries. Ever since, growing numbers of communities favor fluoridation. The mechanism of F prevention of tooth decay is well known: fluoride ions substitute for hydroxyl ions in hydroxyapatite of hard tissues, which result in crystal perfection, with consequent reduction in dental caries. Soluble fluorides such as sodium fluoride are almost completely absorbed from the gastrointestinal tract. However, the presence of divalent or trivalent cations such as aluminum, magnesium, and calcium that can complex with F can reduce the degree of absorption. In U.S.A., over 7000 communities are now adding F to their drinking water. However, some portion of population oppose fluoridation, voicing both concern about the safety of fluoridation as well as for personal choice. Thus, This paper reviews the interaction of fluoride and cations as well as fluoride and suggests possible problems associated with fluoridation, a controversial issue.