To add or subtract fractions with different denominators, one must find the least common denominator and convert the fractions so they have the same denominator. This allows the fractions to be combined properly. The document demonstrates converting 1/2 to 2/4 to add to 3/4, and converting 3/5 to 6/10 to subtract from 7/10. Finding the common denominator and converting the fractions allows for accurate addition and subtraction of fractions.