Opinion of residents from the Gold Coast, Queensland, on community water fluoridation

Water fluoridation in Australia: A systematic review

Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence of water fluoridation in Australia, focusing on the history, health impacts, cost effectiveness, challenges, and limitations. A systematic search was conducted on the Ovid Medline, Web of Science, Scopus, ProQuest Central, Cinahl, and Informit databases to identify literature on water fluoridation in Australia. A grey literature search and backward snowballing were used to capture additional literature. Primary studies, reviews, letters, and opinion papers were included in the quantitative analysis and summarized based on the year of publication and geographical location. The data were extracted from primary studies and summarized under three subheadings: history, community health impacts and the limitations and challenges. Water fluoridation in Australia was first implemented in 1953 in Tasmania. Most states and territories in Australia embraced water fluoridation by 1977 and currently, 89% of the Australian population has access to fluoridated drinking water. Studies report that water fluoridation has reduced dental caries by 26-44% in children, teenagers, and adults, benefiting everyone regardless of age, income, or access to dental care. It has been recognized as a cost-effective intervention to prevent dental caries, especially in rural and low-income areas. Water fluoridation as a public health measure has faced challenges, including political and public opposition, implementation and maintenance costs, access and equity, communication and education, and ethical concerns. Variations in research activities on water fluoridation across Australian states and territories over the last seven decades can be due to several factors, including the time of implementation, funding, and support. Ongoing monitoring and research to review and update optimal fluoride levels in drinking water in Australia is warranted to ensure sustainable benefits on oral health while preventing any adverse impacts.

Community water fluoridation: attitudes and opinions from the New Zealand Oral Health Survey

OBJECTIVE

To report the responses of adult participants in the 2009 New Zealand Oral Health Survey (NZOHS) to questions about community water fluoridation (CWF).

METHODS

The study used quantitative data from the NZOHS. All adult participants aged 18 years and over in the nationally representative NZOHS sample were included in the study (n=3475). Univariate analysis and multinominal logistic regression models were used to examine the associations between variables.

RESULTS

Overall, 57.7% of respondents thought that there were dental benefits to adding fluoride to drinking water and 31.7% responded that they did not know. More than 45% of respondents did not know whether there were health risks from adding fluoride to drinking water. Overall, 42.0% of respondents were strongly or somewhat in favour of CWF.

CONCLUSION AND IMPLICATIONS

People in the Māori, Pacific and Asian ethnic groups, from the two most deprived quintiles, with no education after high school and who brushed their teeth less than twice a day expressed significantly greater uncertainty about CWF than other population groups. This study suggests further research is required to gain a greater understanding of health literacy about CWF and the cultural appropriateness of CWF in NZ.

Impact of initiatives to reduce public dental waiting lists in Queensland, Australia

Information on public dental service waiting lists is available as part of the Queensland Government open data policy. Data were analysed for the period December 2012 to December 2013, to present the total number and percentage of people waiting for care and who have waited beyond the desirable period. Over the 1-year study period, the number of people on the waiting list decreased from 130 546 to 77 146, a difference of 40.9%. A decrease of 80.6% was found for those waiting beyond the desirable period for care. The largest decrease was for general care (44.9%). The initiatives to reduce the public dental waiting list appear to have been successful in significantly reducing the number of people waiting in general and especially those waiting beyond the desirable period. The initiatives to decrease waiting lists represent a downstream approach and are less likely to have any significant impact on the prevention of oral diseases. As waiting lists are reduced, more emphasis should be placed on upstream approaches such as health promotion, specific protection measures and targeting high-risk individuals for oral diseases.