Government of Nova Scotia Government of Nova Scotia Nova Scotia, Canada


Inspection, Compliance and Enforcement


Fluoride and Human Health

Most Nova Scotians are exposed to fluorides on a daily basis, through the trace amounts that are found in almost all foods and through those that are added to some drinking water supplies to prevent tooth decay.

The fluoridation of drinking water supplies is a well-accepted measure to protect public health and is strongly supported by scientific evidence. It continues to be endorsed by over 90 national and international professional health organizations including Health Canada, the Canadian and American Dental Associations, the Canadian Medical Association, the World Health Organization and the Food and Drug Administration of the United States.


Fluoride is found naturally throughout the world -- in soil, fresh and salt water, and in foods. Fluoride may be used by individuals in the form of toothpastes, rinses or applied professionally in the form of gels, foams or varnishes.

In optimal concentrations, fluoride protects the teeth from cavities without any known harmful effects. Fluoridation of drinking water supplies ensures its benefits are equally available to all, regardless of socioeconomic circumstance.

Considerations for Children

Fluoridated toothpaste should be used twice a day to brush teeth. As young children tend to swallow toothpaste when they are brushing, the following guidelines have been established to balance their risk of developing dental fluorosis with the dental health benefits of fluoride.

Children up to 3 years of age should have their teeth and gums brushed by an adult. Parents should consult a health professional to determine whether their child under 36 months of age is at risk of developing tooth decay. If the child is at risk of developing tooth decay, then they should have their teeth brushed by an adult using a minimal amount (rice sized grain) of fluoridated toothpaste. It has been determined that use of fluoride toothpaste in a small amount effectively balances between the benefit of fluoride and the risk of developing fluorosis. If the child is not considered at risk, it is recommended their teeth be brushed by an adult using a toothbrush moistened only with water.

Children 3 – 6 years of age should be assisted with brushing their teeth by an adult and use only a small amount (green pea-sized portion) of fluoridated toothpaste.

Considerations for Adults

High levels of fluorides consumed for a very long period of time may lead to skeletal fluorosis. These levels are much higher than those to which the average Canadian is exposed to daily. Skeletal fluorosis is a progressive but not life-threatening disease in which bones increase in density and become more brittle. In mild cases, the symptoms may include difficulty in moving, deformed bones and a greater risk of bone fractures.

Minimize Your Risk

There are several steps that you can take to maintain your fluoride intake within the optimal range for attaining the dental benefits.

  • Never give fluoridate mouthwash or mouth rinses to children under 6 years of age, as they may swallow it.
  • Talk to your dental professional before using fluoridated mouthwash.
  • Do not use fluoride supplements (drops or tablets) unless specifically recommended by your dental professional.

These guidelines are consistent with recommendations from other health organizations and associations.

Provincial governments regulate the quality of drinking water in their jurisdiction. The fluoridation of drinking water supplies is a decision that is made by each municipality, in collaboration with the Province. The decision may also be taken in consultation with residents. For communities wishing to fluoridate their water supply, the optimal concentration of fluoride in drinking water to promote dental health has been determined to be 0.7 mg/L. Health Canada has established the guideline for fluoride in drinking water as a maximum acceptable concentration (MAC) of 1.5 mg/L. Water containing fluoride at, or below, this MAC does not pose a risk to human health.

Health Canada works in collaboration with provinces and territories to maintain and improve drinking water quality. Together, both levels of government develop the Guidelines for Canadian Drinking Water Quality.

These guidelines are reviewed and revised periodically to take into account new scientific knowledge.

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