The oral health impacts of an almost two-year pause on water fluoridation in the Port Macquarie area, on the NSW Mid North Coast, will not be seen for years, according to a dentist with more than 30 years’ experience.

Fluoridation of the drinking water supply for Port Macquarie and the Camden Haven areas resumed last week, almost two years after it was paused due to a lack of flow in the Hastings River during the drought.

But it is expected to be about 12 months before fluoride levels for the area reach the level required by NSW Health.

Mark Brisley started working as a dentist in Port Macquarie in the 1990s and said it was important children got the right amount of fluoride, as it helped strengthen the enamel while teeth were being formed in the gums.

“If they go through a period of a year or two where they’re not getting the right amount of fluoride in their diet, that will translate to a weaker area of that tooth when it’s being formed,” Dr Brisley said.

He said it could lead to more children needing fillings, as well as hospitalisations for teeth extractions if people did not seek treatment early.

“Children who have multiple holes in their teeth and are in pain quite often have to be admitted to hospital, and have a general anaesthetic with all those attendant risks, to get their oral health under control,” Dr Brisley said.

If poor dental health continued into adulthood, he said there would be links to other health problems.

“There’s a direct link between poor dental health and cardiovascular disease, heart disease in particular,” he said.

“Poor dental health and other conditions, such as diabetes, tend to go hand in hand as well.

The president of the NSW branch of the Australian Dental Association, Kathleen Matthews, said the statistics on water fluoridation spoke for themselves.

“We know that [fluoridated water] is really efficient and has proven over the past 50 years to provide a significant impact on improving the oral health community,” Dr Matthews said.

“If a large-ish population doesn’t have access to fluoride, then what our concern would be is that we would see decay rates increase, particularly for young children and that would be a real concern.”

Most disadvantaged also most impacted

Dr Brisley said fluoride did not eliminate dental decay on its own but adding it to the water supply was a “no-brainer” that saw poorer people in the community reap the most benefits.

“It’s my firm opinion that the people who are least able to pay for dental treatment are the ones who benefit the most from water fluoridation.

“[It’s] one factor of many that leads to good dental health — the other major factor is having access to quality dental care, which unfortunately for many members of society is unaffordable.”

There are more than 6,000 people on the public dental service waiting list in the Mid North Coast local health district, which includes Port Macquarie.

“In the Port Macquarie area, one in seven people have avoided going to the dentist because of the cost involved,” Dr Matthews said.

“They knew that they needed to go, but the cost was one of the things that impacted their decision.

12 months for fluoride level to reach right level

Reports in early August that fluoride had not been added to the area’s drinking water since November 2019 came as a shock to many residents.

Fluoridation started in the Port Macquarie-Hastings Council area in 2012 but has never reached a reporting benchmark set by NSW Health.

“The reporting level is above 0.95 milligrams a litre for a consistent period over three months,” the council’s director of infrastructure, Dan Bylsma, said.

“We have, in fact, reached that level of 0.95mg/L as recently as 2019, just not for that entire three-month period.”

He said the level was reached for less than three months around October 2019, the month before fluoride dosing was paused.

Following the almost two-year fluoridation pause, the level in the Port Macquarie dam is currently one-tenth of the required one milligram per litre, which NSW Health said was reflective of what was seen in natural environs.

Mr  Bylsma said, all going well, the level in the dam should rise to where it needs to be in about 12 months’ time.

“We’re dosing anything that we can extract from the Hastings River with 1mg/litre,” he said.

“We anticipate that if those conditions prevail, where we can continue to extract from the Hastings with good flows, we should see the Port Macquarie dam at a level of around 1mg/litre within 12 months time.”

An email seen by the ABC, from the area’s health district to a local doctor, said council advised if it recommissioned the existing dosing plant it would take five to seven years for the supply to reach the reportable fluoride level.

Council said the 12-month timeline was reliant on there being sufficient flows in the Hastings River, and it would minimise top-ups with unfluoridated water from Cowarra Dam to limit dilution effects.

Fluoridation resumed in nearby Wauchope in April and, as the water flows straight from the river through the treatment plant and into reservoirs, it has already returned to the required level.

Looking to the future

Port Macquarie-Hastings Council currently fluoridates the supply for Port Macquarie and the Camden Haven as it is taken out of the river and fluoridated water is stored in Port Macquarie Dam.

As part of the council’s long-term plans, it is working on a new water treatment plant, at Cowarra Dam, between Wauchope and Port Macquarie, which it said would provide a more consistent fluoride dosing system.

“It will be less prone to seeing that fluctuation because it will be a beyond-the-dam dosing plant whereas at the moment we are dosing pre-dam,” Mr Bylsma said.

“That provides the ability to get that 1mg/litre consistently dosed as a post-dam exercise and control that across our broader network.”

The new water treatment plant is scheduled for completion between 2026 and 2028.

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*Original article online at https://www.abc.net.au/news/2021-09-22/port-macquarie-council-resumes-fluoridation/100476962