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Dental health education

Fluoride is not added to Niagara's tap water

Since fluoride levels in Niagara's water are too low to prevent cavities effectively, it's especially important to brush twice daily with fluoride toothpaste and consider fluoride treatments from your dentist.

Fluoride treatments

  • Fluoride varnish for children under five (safe from first tooth, applied twice yearly)
  • Topical fluoride applications at dental appointments
  • Fluoride mouthwash for ages six and older only (not for younger children)

Free fluoride varnish is available at daycares, dental offices, EarlyON Centres, physician offices, Public Health clinics and schools. Learn about the fluoride varnish program.

How to prevent cavities

Untreated tooth decay can lead to pain, infection and problems with eating, speaking and learning. Dental cavities are the most common chronic disease in children ages five to 18, but they're largely preventable with proper care.

Brush twice daily

Brush teeth twice daily for two minutes with fluoride toothpaste.

Toothpaste amount by age

Under 3 years: Rice grain-sized portion of fluoride toothpaste

  • Adult should apply toothpaste
  • Adult should brush child's teeth
  • Supervise to ensure proper brushing

3 years and older: Pea-sized portion once child can spit out

  • Continue supervising children under six years
  • Ensure child can spit out toothpaste

Additional care

  • Floss daily
  • Visit dentist by age one or as soon as first tooth appears
  • Visit dentist twice yearly
  • Don't give mouthwash to children under six

Foods to limit

  • Sticky, sugary and salty snacks
  • Starchy foods (pretzels, crackers, chips) which contain hidden sugars that contribute to tooth decay
  • Pop, juice and sports drinks

Best choices

  • Drink water instead of sweetened beverages
  • Choose fresh fruits and vegetables

For babies and toddlers

  • No juice for babies; offer water and milk only
  • Avoid constant sipping from bottles or sippy cups
  • Bedtime bottles should contain water only
  • Introduce open cup at six months
  • Transition fully to open cup by 12 months

Learn more about healthy eating with Canada's Food Guide.

Baby teeth are important

Babies can get cavities as soon as the first teeth appear. Learn when your child's baby teeth should come in. Baby tooth decay can also cause problems in adult teeth.

Check your baby's teeth monthly

Lift your baby's lip once a month to look for early signs of tooth decay. Early detection means decay can often be reversed before it needs treatment.

Original concept and graphics produced by South Australian Dental Service.

Healthy baby teeth with no spots or markings on the gums or teeth

Healthy mouth and gums

Pink, healthy gums with white teeth. No spots, discolouration or unusual markings.

Baby teeth in very early decay with white or chalky spots near the gum line. The image has arrows pointing to these spots

Very early decay

White or chalky spots near the gum line. Can be reversed if found early. See dentist immediately.

Baby teeth with brown spots visible on the teeth and gumline

Brown spots or decay

Brown spots or visible decay across the gum line. Requires dental treatment. Make appointment soon.

Baby teeth with severe decay and large brown spots

Advanced decay and infection

Urgent treatment needed. Multiple damaged teeth, visible infection, possible pain. Call Dental Health immediately.

Understanding fluoride

Fluoride is a naturally occurring mineral that strengthens tooth enamel and protects teeth from childhood through senior years. Understanding how to get adequate fluoride is especially important for Niagara residents.

Niagara Region does not add fluoride to tap water

While fluoride occurs naturally in our water, the levels are too low to provide effective cavity prevention.

The 2025 annual water quality reports for Niagara show no detectable fluoride levels in the water facilities / plants in Decew, Niagara Falls, Port Colborne, Rosehill and Welland, with a maximum of 0.07 mg/L in the Grimsby plant (serving Grimsby, West Lincoln and a portion of Lincoln).

In Ontario, 74.7 per cent of the population has access to fluoridated tap water. Learn about the State of Community Water Fluoridation across Canada.

For more information, view Niagara's water quality reports [needs link].

What this means for you:

  • Brushing with fluoride toothpaste twice daily is essential
  • Ask your dentist about professional fluoride treatments
  • Children under five should receive fluoride varnish twice yearly

How fluoride works

  • Strengthens tooth enamel (the outer protective layer of teeth)
  • Makes teeth more resistant to acid attacks from bacteria
  • Protects teeth from childhood through senior years
  • Prevents cavities, which can lead to pain, infection and tooth loss
  • Helps repair very early decay before it becomes visible

Sources of fluoride

Fluoride is a naturally occurring mineral found in water, plants, rocks, soil, air and most foods. You can get fluoride through:

  • Fluoride toothpaste (most important source in Niagara)
  • Professional fluoride treatments at dental appointments
  • Fluoride varnish for young children
  • Fluoride mouthwash for ages six years and older (not for younger children)

What is water fluoridation?

Community water fluoridation is the process of adjusting the level of fluoride in public drinking (tap) water to optimize the dental benefits of preventing tooth decay. It's recognized as the single most effective public health measure to prevent tooth decay.

Fluoridation in Ontario

  • 70 per cent of Ontario's population has access to fluoridated tap water
  • Fluoridated water provides additional protection beyond fluoride toothpaste
  • Community water fluoridation benefits all ages

Scientific support

Over 90 global health organizations support community water fluoridation to prevent tooth decay, including:

What is dental fluorosis?

Too much fluoride from any source (including toothpaste) can cause dental fluorosis—white chalky spots on teeth. This is a cosmetic condition and not harmful to health.

Prevention

  • Use age-appropriate amounts of toothpaste (rice grain size for under 3, pea size for 3+)
  • Supervise young children while brushing
  • Ensure children spit out toothpaste, not swallow
  • Inform dental professionals if child receives fluoride varnish from multiple sources

Dental fluorosis is very uncommon in Niagara due to low fluoride levels in tap water.

Have a question?

Contact Dental Health