Ontario public health units are expanding dental screening and fluoride varnish programs into daycare centres and early childhood settings, targeting children under five who are most vulnerable to preventable tooth decay. A Wellington-Dufferin-Guelph Public Health pilot screened 123 children across seven daycares and delivered fluoride varnish to 100 of them — and the program is now scaling to additional sites across the region in 2026.
As of August 2026, the push to bring preventive dental care directly into childcare settings marks a significant shift in how Ontario approaches children's oral health. Rather than waiting for families to seek out dental care — which many lower-income families delay or avoid entirely — public health units are meeting children where they already are: in licensed daycare centres, nursery schools, and early learning programs across the province.
For dental professionals in Ontario, particularly those in the Greater Toronto Area and surrounding communities, these expanded screening programs have direct implications for referral patterns, patient acquisition, early intervention workflows, and the broader public health landscape that shapes demand for paediatric dental services.
What the Wellington-Dufferin-Guelph Pilot Revealed
The Wellington-Dufferin-Guelph (WDG) Public Health unit launched a daycare-based dental screening and fluoride varnish pilot program targeting children aged one to four. Seven licensed daycare centres across Guelph and Wellington County participated in the initial phase.
The pilot's numbers tell a clear story: 123 children were screened on-site by public health dental staff, and 100 of those children received fluoride varnish applications during the same visit. The program identified children with urgent dental needs and referred them directly to community dental providers or to the health unit's own clinic programs for follow-up treatment.
WDG Public Health has announced plans to expand the program to additional daycare sites across the region throughout 2026, with the goal of making dental screening and fluoride varnish a routine part of the early childhood care experience — similar to how vision and hearing screenings are already integrated into school health programs.
Pro Tip: If your practice is near a public health screening site, introduce yourself to the local public health dental coordinator. Many families identified through screening programs are referred to community dentists for follow-up treatment — being on the referral list can generate a steady stream of new paediatric patients.
The Evidence Behind Fluoride Varnish in Early Childhood
Fluoride varnish is a concentrated fluoride coating painted directly onto the tooth surface. When applied twice annually, it has been shown to reduce dental caries in primary teeth by 30 to 35 percent, according to systematic reviews of the evidence. The application takes under five minutes per child, requires no special equipment beyond the varnish itself and a disposable applicator, and is well-tolerated even by very young children.
The case for delivering fluoride varnish in daycare settings is straightforward: children under five are at the highest risk for early childhood caries (ECC), a condition that disproportionately affects children from lower-income families, Indigenous communities, newcomer populations, and rural areas where access to dental care is limited. In Ontario, early childhood caries remains one of the leading causes of day surgery under general anaesthesia in children — a costly, resource-intensive, and traumatic intervention that effective prevention programs can reduce.
The University of Toronto Faculty of Dentistry has been at the forefront of researching how to integrate fluoride varnish application into primary healthcare settings beyond traditional dental offices. A project titled "An Ontario Primary Health Care System to Support a Cavity-free Future" aims to make fluoride varnish application a routine part of primary care practice across the province — not just in dental clinics, but in physician offices, community health centres, and public health settings.
The Scale of Ontario's School and Daycare Screening Programs
The WDG daycare pilot is part of a broader network of dental screening programs operating across Ontario's 34 public health units. Under the Ontario Public Health Standards, health units are mandated to provide oral health assessment, surveillance, and preventive services to priority populations — including children in publicly funded schools.
WDG Public Health alone screened over 11,000 children during the 2024-2025 school year through its school-based dental assessment program. Of those, 209 children were flagged for urgent dental needs requiring immediate treatment referral, and 858 were identified with non-urgent dental needs requiring follow-up care. These numbers represent a single health unit in a mid-sized Ontario community — the province-wide figures are substantially larger.
Other Ontario health units running similar programs include the Middlesex-London Health Unit, which operates a free fluoride varnish program in participating childcare centres across London and Middlesex County; the Niagara Region Public Health unit, which offers fluoride varnish for children under five through its dental clinics and community programs; the Porcupine Health Unit in Timmins, which provides dental services to children and families in underserved northern communities; and the Thunder Bay District Health Unit, which runs a fluoride varnish program targeting children in childcare settings across the Thunder Bay region.
Why This Matters for Dental Practices
For private dental practices, expanded public health screening programs create several practical effects worth understanding.
Increased Referral Volume for Paediatric Services
Children identified through screening programs who need treatment beyond what public health clinics can provide are referred to community dental practitioners. Practices that establish relationships with their local public health dental coordinators — and that demonstrate capacity and willingness to treat young children — are more likely to receive these referrals. This is particularly valuable for practices in communities where paediatric dental specialists are limited or have long wait times.
Earlier Presentation of Dental Disease
Screening programs identify carious lesions and other oral health issues at earlier stages than would typically occur if families waited until a child complained of pain. For dental practices, this means seeing more children with early-stage disease amenable to conservative treatment (silver diamine fluoride, interim therapeutic restorations, preventive resin restorations) rather than the extensive restorative or surgical interventions required when disease is advanced.
Greater Parental Awareness
When public health staff screen a child and send home a letter identifying dental needs, parents are substantially more likely to seek care than they would have been without the prompt. This awareness effect benefits all dental practices in the community, not just those receiving direct referrals from the health unit. Parents who receive screening results often discuss them with neighbours, friends at the daycare, and family members — creating a secondary referral effect.
Pro Tip: Consider offering a "screening follow-up" appointment pathway for families coming from public health referrals. These families may be new to private dental care, unfamiliar with dental insurance processes, or anxious about costs. A welcoming, judgment-free intake process — with clear explanations of what treatment will cost and what the Canadian Dental Care Plan (CDCP) or Healthy Smiles Ontario may cover — can convert a one-time referral into a long-term patient relationship.
The CDCP Connection: Federal Coverage Meets Provincial Prevention
The expansion of Ontario's preventive screening programs is happening alongside the ongoing rollout of the Canadian Dental Care Plan (CDCP), which in its 2026-2027 benefit year covers eligible Canadians across all age groups — including children. This creates a dual access pathway: public health screening identifies children who need care, and the CDCP provides a coverage mechanism for families who might otherwise face financial barriers to treatment.
For dental practices participating in the CDCP, the combination of expanded screening and federal coverage could increase the volume of paediatric patients presenting for treatment. Practices that have not yet registered as CDCP providers should consider doing so, particularly those located in communities served by active public health screening programs where newly identified families will be seeking care.
The Ontario government's Healthy Smiles Ontario (HSO) program also continues to provide free preventive, routine, and emergency dental services to children and youth from low-income families who are not covered by any dental insurance. Together, HSO, the CDCP, and public health screening programs form a multi-layered safety net designed to ensure that no Ontario child goes without basic dental care.
Challenges and Gaps That Remain
Despite the progress, significant challenges persist. Not all Ontario health units have the same level of resourcing for dental screening programs. Northern and rural health units — which serve the communities with the highest rates of early childhood caries — often have the fewest dental public health staff and the largest geographic areas to cover. The gap between urban and rural access to preventive dental services remains one of Ontario's most persistent oral health inequities.
Workforce availability is another constraint. The province-wide shortage of dental hygienists and dental assistants affects both private practices and public health units. Health units competing for the same limited talent pool as private practices may struggle to staff expanded screening initiatives, even when funding is available.
Parental consent can also be a barrier. Daycare-based screening programs require individual parental consent for each child, and opt-in rates vary significantly by community and by how effectively the consent process is communicated. Health units that have invested in multilingual consent materials and parent information sessions report higher participation rates than those relying solely on English-language permission forms.
Pro Tip: If you serve a community with a high proportion of newcomer families, consider having your consent and new patient forms available in Mandarin, Punjabi, Tamil, Arabic, and Farsi — the most common non-English languages in the GTA. This simple step can remove a significant barrier for families referred from public health screening programs.
Looking Ahead: Integrating Dental Prevention into Primary Care
The University of Toronto Faculty of Dentistry's research project on integrating fluoride varnish into primary care represents the next frontier. If Ontario succeeds in making fluoride varnish application a routine part of well-baby visits at physician offices and community health centres — not just dental offices — the province could see a measurable reduction in early childhood caries rates within a generation.
For dental professionals, this would mean a shift in the role of private practice from primary prevention (which would increasingly happen in non-dental settings) toward treatment, monitoring, and complex care management. It is a model that has been implemented successfully in several other jurisdictions, and Ontario's research infrastructure, combined with its public health mandate, makes it a strong candidate for implementation.
EBIKO Dental will continue monitoring the expansion of Ontario's dental screening and preventive care programs and reporting on developments that affect dental practices across the province.
Frequently Asked Questions
Q: Are Ontario daycare dental screening programs mandatory for children?
No. Daycare-based dental screening programs in Ontario require individual parental consent for each child. They are offered as a free public health service through local health units, not mandated by the province. School-based screening programs operate under the Ontario Public Health Standards, and while health units are mandated to offer them, individual families can decline participation for their children.
Q: Does fluoride varnish replace regular dental visits for young children?
Fluoride varnish applied in daycare or school settings is a preventive supplement, not a replacement for comprehensive dental care. The Canadian Dental Association (CDA) recommends that children see a dentist within six months of the eruption of their first tooth, or by age one. Public health fluoride varnish programs are designed to reach children who may not have access to regular dental visits and to provide an interim layer of protection while families establish a dental home.
Q: How can dental practices in Ontario connect with public health screening referral networks?
Contact the dental health coordinator at your local public health unit and express your practice's interest in accepting referrals from screening programs. Provide information about your hours, location, the age range you are comfortable treating, and whether you accept Healthy Smiles Ontario, CDCP, or other public coverage. Building a personal relationship with the public health dental team in your community is the most effective way to be included in referral networks.