Ask Dr. Marla: Non-Flouridated Water

By Dr. Marla Shapiro on February 24, 2010
I recently found out that our town water supply is not treated with fluoride (I had assumed it was). Is there any special treatment to consider for our three-year old son since he is not old enough for fluoride toothpaste?

The cavity-preventing effectiveness of fluoride is well established, but too much fluoride can be dangerous and cause a condition known as fluorosis.
This is a condition that discolours or spots developing teeth. Adults should brush teeth of children younger than three, using a minimal amount or smear of fluoridated toothpaste to avoid excessive swallowing.
The use of fluoride supplements before the eruption of the first permanent tooth is generally not recommended.
Health Canada, through a joint federal/provincial committee, is responsible for watching the level of fluoridation in water supplies. In recent years, this committee has recommended that optimal levels of fl uoride should be between 0.8 and 1.0 parts per million. This recommendation is based on the fact that many Canadians receive fluoride from many sources. As a result,
some communities have lowered the level of fluoride in their water supply, in keeping with this recommendation.
Even though your child isn’t receiving fluoride from the water supply, he is likely receiving some from other food sources that are prepared in areas where fluoridation is occurring. Fluoride supplements need only be considered for patients at high risk for dental caries (cavities) and even then may be unnecessary if patients are receiving adequate fluoride from other sources.
Supplementation, in liquid or chewable format, has proven useful in protecting patients at high risk of cavities or living in areas with high rates of cavities. Your dentist will discuss any treatment option with you. A good online reference by the Canadian Dental Association can be found at

Published March 2010

By Dr. Marla Shapiro| February 24, 2010

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