The purpose of this study was to evaluate the difference in dental caries and fluorosis prevalence in 936 randomly selected life-long residents selected from public and private schools in Trois-Rivières (1.0 ppm Fin 1987) and Sherbrooke ( < 0.1 ppm F), Que., Canada. Students, 11–17 years of age, were examined for dental caries using the National Institute for Dental Research criteria and for dental fluorosis using the Tooth Surface Index of Fluorosis. Because of an inconsistent fluoridation history in Trois-Rivières, comparisons were carried out between two age strata: students 11–14 years of age who consumed for a longer duration suboptimally fluoridated water than those in the second stratum: students 15–17 years of age. Only public school students, 15–17 years of age, from Trois-Rivières had significantly lower mean filled surface and decayed, missing, and filled tooth surface (DMFS) scores (28 and 24%, respectively) than similar students in Sherbrooke. Among private school students, differences were not found, except in the youngest age group in Sherbrooke who had significantly lower mean DMFS than similar students from Trois-Rivières. The prevalence of fluorosis was 45.6% and 58.0% in Trois-Rivières public and private schools, respectively, and 31.1% and 30.1% in Sherbrooke public and private schools, respectively. The use of fluoride tablets was significantly associated with fluorosis. This study showed that water fluoridation benefitted students from public schools and that the risk factors for dental fluorosis were the use of fluoridated water and fluoride tablets.

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