The Palaszczuk government has been accused of a major public health failure, with more than a quarter of Queenslanders having no access to a fluoridated water supply.

More than a decade after the Newman LNP government handed decision-making on water fluoridation to local governments, 51 out of 77 councils do not have fluoridated water, including major regional centres such as Bundaberg, Rockhampton, Mackay and Cairns.

That’s despite water fluoridation being hailed by the US Centers for Disease Control and Prevention (CDC) as one of the top 10 public health achievements of the 20th century.

This year marks the 70th anniversary of fluoride being first introduced to drinking water in Australia at Beaconsfield in Tasmania, followed three years later by Yass in NSW.

In 2023, about 90 per cent of Australians can access fluoridated water — but only 72 per cent of Queenslanders do, most of them in the state’s populated south-east corner.

Dentists, doctors and public health specialists have all called on the Palaszczuk government to end the disparity.

The Australian Dental Association of Queensland (ADAQ) described fluoridation as “one of the cornerstones of modern preventive dentistry”.

ADAQ spokeswoman Norah Ayad, a Gold Coast-based dentist, said water fluoridation had the potential to benefit everyone, but particularly those at greatest risk of tooth decay, including young children and the elderly.

Dr Ayad said it made little sense that a public health measure was left to the decision of local councillors with no public health training or knowledge.

Australian Medical Association Queensland (AMAQ) vice-president Nick Yim — a general practitioner in Hervey Bay, which does not have a fluoridated water supply — described mandated fluoridation as “a basic human right”.

“It’s a health issue,” Dr Yim said.

“We are seeing increased tooth decay, a decline in oral health within our communities and hence, an increase in chronic disease.

“We would like to see the Queensland government immediately return and mandate fluoridation in our water supplies.”

Vulnerable communities could benefit from fluoride

Queensland local government areas that fail to fluoridate their water supplies serve some of the state’s most vulnerable residents, including Aboriginal and Torres Strait Island communities, apart from Kowanyama, which has naturally occurring fluoride in its water supply.

“The government regularly pays substantial aerial ambulance costs to bring children from remote communities to Mount Isa or Cairns for dental general anaesthetics,” the ADAQ said in a statement.

“Some of that money would be far better spent ensuring water fluoridation reaches all Queensland, to reduce dental caries in the first place.”

Dr Ayad said fluoridated drinking water in Aboriginal communities would help close the gap.

She said the evidence was clear that water fluoridation improved oral health, with dental disease in the Logan area dropping 20 per cent within three years of water fluoridation being introduced to south-east Queensland in 2008.

In 2022-23, Queensland Health data shows 4,137 children aged 10 and under were admitted to Queensland hospitals for dental caries – up from 3,704 the previous financial year.

A National Health and Medical Research Council evidence evaluation in 2016 found water fluoridation reduced tooth decay by between 26 and 44 per cent in children, teenagers and adults.

“It needs to be a priority, at the end of the day the burden on health and the burden to the community far outweighs the investment in the infrastructure and resourcing required,” Dr Ayad said.

“We know it works. We know it can reduce dental decay, we know it can make our Queenslanders healthier, so we need to take action on it, it’s well overdue, we need to see action.

Townsville has had fluoridated drinking water since the mid-1960s – about four decades before former premier Anna Bligh made it mandatory across the rest of the state for drinking water supplies serving communities of more than 1,000 people.

Her successor Campbell Newman scrapped the mandate in 2012, handing the decision to councils. Most have since opted out of fluoridation.

Reasons given to the ABC range from the prohibitive cost of water fluoridation, to surveys suggesting most residents failed to support fluoride.

Council rejects ‘mass involuntary medication’

The Cairns Regional Council cited one of the reasons for axing water fluoridation as “a principle of ethical public health policy that mass involuntary medication should not proceed without the express consent of the community”.

Cassowary Coast Regional Council mayor Mark Nolan said while he believed fluoridation was critical for the good oral health of people living in lower socio-economic areas, now was not the right time to revisit the issue.

“People were terrified of the COVID injections, we had protest rallies around it. It would be a terrible time to try and force fluoride,” Councillor Nolan said.

“But if it were to raise its head in the near future, I do believe the state government should take responsibility for mandating it, not leaving it to individual councils. That’s very unfair.

Water fluoridation has undeniably been controversial in Queensland. Some anti-fluoride campaigners have civil rights objections, while others believe it lowers the IQ of children – a claim debunked by recent Queensland research.

“We’re talking about one part per million in a water supply — it’s just not capable of causing the negative effects that people are concerned about, but we can absolutely see the health benefit of it,” Dr Ayad said.

“We have studied water fluoridation for decades and the results cannot be questioned. At a population level, and even at an individual patient level, we see a reduction in dental disease.

“Preventable dental conditions that are left untreated end up in infections. Infection spreads, it spreads all the way over the body and the mouth is not disconnected from the rest of our bodies.”

Health Minister Shannon Fentiman said she wanted to see the percentage of Queenslanders in receipt of fluoridated water to “climb even higher”, but said the Palaszczuk Government was committed to “local decision-making”.

“Local governments have the power to decide if water fluoridation is in the best interests of their communities,” she said in a statement.

“But we acknowledge that water fluoridation can be challenging for some local governments, due to supply chain issues, lack of fully-trained water treatment plant operators, and lack of support from their community.

Ms Fentiman said she was committed to working with the Water Minister Glenn Butcher, local governments, the ADAQ and the AMAQ “to understand how we can encourage and promote the uptake of this important public health initiative”.

“Fluoridation is a safe and effective way to prevent tooth decay for people of all ages,” she said.

“In communities where fluoridated water is not available, I encourage people to talk to their dentist about other ways to get fluoride.”

*Original full-text article online at: https://www.abc.net.au/news/2023-11-20/qld-fluoride-access-issues-tooth-decay-dental-care-oral-health/103099734