i live in Oregon where we dont have flouride added to water. toothpaste works for adults, for kids...doctors and dentists provide flouride paste onto kids teeth usually at routine checkups and also my doc prescribed a little bottle of flouride you can give to your kid daily to make sure they dont fall prey to early tooth decay ( at least they did for me and all my friends kids). there is lots of ways to handle it in my experience when its not in the water.