FULLY FLUORIDATED QUEENSLAND: STILL A PIPE DREAM?

Optimised water fluoridation is a safe public health measure proven essential, but its implementation in Queensland is still in the wrong hands.

In November 2023, ADAQ answered ABC News’ questions on the state of public water fluoridation in Queensland.

In the interview, ADAQ Past President, ADA 2023 Federal Councillor for Queensland, and Gold Coast dentist, Norah Ayad reiterated a simple fact: fluoridation is an essential public health measure, and as such, it is a state government’s responsibility, and should not be left in the hands of local councillors.

The State has a responsibility to make decisions for the best possible community health outcomes. This is not happening in Queensland today, whenever a decision is made against water fluoridation.

Since the Newman LNP government changed the legislation in 2012, Councils retained the power to elect whether to fluoridate local water supplies or not. Many have decided against it.
Public water fluoridation has been available in Australia for over 70 years. It is still the easiest, safest and most socially equitable method to provide the dental health benefits of optimally fluoridated water, to the greatest number of people.

"The government regularly pays substantial aerial ambulance costs to bring children from remote communities to Mount Isa or Cairns for dental procedures under general anaesthetics. Some of that money would be far better spent ensuring water fluoridation reaches all Queensland, to reduce dental caries in the first place."

Children and adults in non-fluoridated communities suffer significantly more dental caries (tooth decay) than in fluoridated communities. Optimised water fluoridation has the potential to benefit everyone, and particularly those who are at greatest risk of tooth decay, such as young children, the elderly, and Aboriginal and Torres Strait Islander people. And yet, many Queensland local government areas that don’t fluoridate their water supplies serve some of the state's most vulnerable residents, including many Indigenous communities.

Currently (2023) 51 out of 77 councils do not fluoridate water, and only about 72% of Queenslanders have access to fluoridated drinking water, against a 90% average nation-wide. Many of our members and their teams continue to see the sad results of our state lagging behind in their practices.

Mandate where practical, support where not

ADAQ again must call on the state government to restore its power to mandate water fluoridation where is practical, and to actively support the delivery of additional and alternative measures for communities where public fluoridation may still not viable. In Queensland, we have of course areas where communities rely on untreated bore water, already have naturally fluoridated water, or have issues with potable water. In these areas a large fluoride plant would not be needed. Years ago, that may have been the reason for halting fluoridation plans in some areas. However, today there are alternatives that the Qld Government should explore, such as simple tablet dosing systems used in the US which may be suitable for smaller communities. Any government water infrastructure grants to councils to replace or upgrade water treatment plants, install water pipes to new suburbs etc. should be made conditional on councils installing and operating water fluoridation plants. Any capital costs should be borne by the state government.

It may take a while to reverse the 2012 changes to the Water Fluoridation Act 2008. Meanwhile funding should be allocated in the 2024 state budget to:

• meet costs to research modern fluoridation options and reinstate water fluoridation in local government areas that do not currently fluoridate community water supplies; and
• deliver public education campaigns to inform Queenslanders and their local councillors about the safety and efficacy of fluoridated water and debunk harmful myths.

Until the mandate is reinstated, though, the decision power will remain on local Councils.
As health practitioners, Queensland dentists and their teams respectfully urge all Councils considering changes to water fluoridation to maintain this vital public health measure for the benefit of all Queensland residents.

See ADAQ’s position statement on fluoridation here and past campaigns and releases on the topic here and here.

ADAQ welcomed Premier Palaszczuk’s comments at a recent media conference, that her government is open to discuss water fluoridation.   

Here at ADAQ, we are looking forward to collaborating with the Queensland Government and other stakeholders on educational campaigns, as well as working on solutions for expanding access to much needed dental care and oral health education, especially for disadvantaged cohorts. 

Forwards and backwards – a Queensland fluoridation history

ADAQ has a long history of actively advocating in favour of public water fluoridation, always a highly politicised topic in Queensland [see HF Akers and MA Foley, Fluoridation advocacy in Queensland: a long and winding road, IDJ. 2012;61:262-269].

Since the 1970s, Townsville teeth shone brightly in epidemiology studies. The 1994 ADAQ campaign ‘Save More Teeth’ for Southeast Queensland was very energetic and community polling at the time showed high support for fluoridation. However, the Lord Mayor’s Taskforce on Fluoridation ensured Brisbane would remain the only unfluoridated major city in Australia for a little longer.

It’s almost two decades since the Forster Report (Queensland Health Systems Review, 2005) recommended Queensland review its fluoridation policies to halt the decline in the oral health standards of Queenslanders, the worst in the nation at the time. Only about 5% of Queensland was optimally fluoridated at the time.

ADAQ’s 2006 campaign rode the support wave of Bligh’s Labor government for fluoridation, which and ‘ended 50 years of fluoridation-related impasse in Queensland (Akers & Foley 2012) with first Water Fluoridation Act 2008. The dental profession’s efforts to stamp out unscientific and dangerous counter-arguments seemed to have finally paid off. The heavy personal toll endured by many of ADAQ spokespersons, who were targets of smear campaigns and violent threats, was somewhat offset by the state government listening to the right ears.

Right: Photo of fluoridation reports and leaflets. [ADAQ archives]
Below: Photo of 4-year-old child’s mouth with caries from ADAQ’s Save More Teeth – A proposal for Water Fluoridation in Queensland booklet, [ADAQ, 1988].

It was however a short-lived gain for the many communities who stood to benefit from mandatory public fluoridation. Inexplicably, in 2012 Campbell Newman’s LNP government returned the decision power on this important public health measure to local councils.

Since then, many councils have remained unfluoridated, or stopped fluoridation, citing increasing maintenance and staffing costs.

See Forty FAQs on Fluoridation
Learn more about the benefits of fluoride: www.teeth.org.au/dental-fluoride