Less than 75% of Queenslanders have access to fluoridated water – and it’s putting oral health at risk

Recently, healthcare professionals called on the Queensland Government to mandate Fluoride in Drinking Water throughout the state. This is because the water fluoridation coverage of the state lags other Australian States and Territories.

What are the benefits of adding fluoride to our drinking water? Why do more than a quarter of Queenslanders have no access to fluoridated water, while the majority of Australians have it?

What is water fluoridation, first of all?

Fluoride, a naturally occurring element, is best known for strengthening teeth. Fluoride makes our teeth more resistant to dental caries.

Water fluoridation, a public health program that aims to reduce dental decay in the population, is an effective way to combat this problem. The fluoride is added to the public water supply systems. In Australia, recommended fluoride levels in public water supply range from 0.66 to 1.1mg per liter.

The United States was the first country to introduce water fluoridation. Grand Rapids, in Michigan, was the first city to fluoridate water. The US Centers for Disease Control and Prevention cited water fluoridation as among the ten greatest public health achievements in the 20th century.

Since 1953, fluoride has been added to the water supply in Australia, beginning in Beaconsfield in Tasmania. Today, more than 90% of Australians are able to access fluoridated drinking water.

Most Australian States and Territories have passed laws that require fluoridation in public water supplies. Queensland is the only exception, as it has left this decision to local governments.

Read more: Four myths about water fluoridation and why they’re wrong

The evidence

Water fluoridation has been proven to be a safe, effective method of improving oral health. The Australian Dental Association, the World Health Organization, and the International Association for Dental Research all endorse water fluoridation.

We need to collect data regularly on the effectiveness of a large-scale program such as water fluoridation.

I was involved with the National Child Oral Health Study, 2012-14, which collected data from more than 24,000 Australian children. Water fluoridation is effective at preventing dental caries. In 2015, I published a study that included more than 5,000 children from Queensland. The results showed that water fluoridation decreased dental decay by 40 percent.

Water fluoridation can protect against tooth decay. AnnaStills/Shutterstock

In 2017, the National Health and Medical Research Council reviewed studies that showed water fluoridation could reduce dental caries in children and adults by up to 27%. Fluoridation has been associated with less caries among adults.

The cost-effectiveness of water fluoridation was also found to be. Investments in these programs could result in significant savings by improving the oral health of the population.

Can fluoridation reduce disparities in oral health inequalities?

Oral health is affected by social factors like income and background. For example, poorer people from culturally and linguistically diverse backgrounds or First Nations Communities often have worse oral health than the general population.

According to my research, exposure to fluoridated drinking water is associated with reduced inequalities in child oral care related to household income and Indigenous Status. This is what we would expect due to the passive delivery of fluoride. People can still benefit from drinking fluoridated water regardless of their socioeconomic status.

Potential side effects

Water fluoridation is known to cause dental fluorosis, which results in changes in the color of the tooth enamel. Dental fluorosis is also a result of other fluoride sources, such as toothpaste containing fluoride and fluoride treatments at the dentist during childhood. In Australia, dental fluorosis is usually mild or very mild. It does not have any long-term consequences for oral health.

The NHMRC’s review concluded that water fluoridation does not pose any other risks.

Most of Australia’s water is fluoridated. New Africa/Shutterstock

Fluoridation is a controversial topic. Many councils have vocally opposed small groups.

A recent argument against fluoridation claims that early intake of fluoride in childhood is linked to child development, especially lower scores on IQ. These arguments are based on poorly designed studies or areas that have high natural fluoride levels and other heavy metals.

It’s not surprising that this issue has raised concern.

Recent large-scale reviews investigated this possible link. The studies in 20202021, and 2023 concluded that fluoride in water fluoridation was not associated with reduced cognitive abilities among children.

To investigate this problem, my colleagues and myself also conducted a study in Australia. Data was collected from more than 2,600 children in a national sample. We found that early exposure to fluoridated drinking water had no impact on the child’s development.

The water fluoridation practiced in Australia and around the world is safe for children.

Read more: Collaborating with Communities Delivers Better Oral Health for Indigenous Kids in Rural Australia.

Where to from here?

Many rural communities in Victoria are also missing out on fluoridated drinking water.

Water fluoridation is a cornerstone in the prevention of tooth decay, which can cause other oral health and general issues.

All levels of government and health organizations should support, maintain, and expand water fluoridation programs.


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