Well-planned, new initiatives are required to preserve fluoride uses, especially water fluoridation. Discussed are barriers to fluoride promotion, evidence about public and health-care providers' knowledge and opinions about fluoride use and decision making, implications of sources of public information on fluorides, consequences to professionals and the public of being misinformed about fluorides, and four general strategies for promoting fluorides under varying conditions. Educational and political initiatives must be appropriate to state needs and conditions. Four broad categories of actions include: diagnosis and planning for education/promotion; public and professional education under both noncontroversial and controversial conditions, political persuasion where required, and changing the context of fluoridation decision making to prevent public referenda on public health measures.