Water fluoridation is effective in preventing tooth decay overall, but there are greater benefits for children from lower socio-economic backgrounds, University of Queensland research has found.
Professor Loc Do from UQ’s School of Dentistry, and researchers from the Institute of Science Tokyo, Japan and the University of Adelaide, conducted a study that examined Australian children’s exposure to fluoridated water and compared it to demographic factors such as socio-economic status, parental background and geography.
“We found while water fluoridation helps prevent tooth cavities across the board, it is more beneficial for vulnerable populations,” Professor Do said.
Researchers analysed oral health data of 17,500 children aged five to 14, which was captured during the National Child Oral Health Study (NCOHS) in 2012–2014, and published their findings in the International Journal of Epidemiology.
“While there is a lot of scientific evidence that water fluoridation as a population strategy prevents dental cavities, there is little known about how water fluoridation impacts health inequalities—and that’s what we wanted to explore,” Professor Do said.
“We looked at the data of children who had been fully, or never, exposed to fluoridated water, so we could capture the effect of fluoride on preventing tooth decay.
“Using a unique algorithm, we then analysed this data alongside 47 different child demographic, socio-economic and parental factors.”
Associate Professor Yusuke Matsuyama, from the Institute of Science Tokyo, said children who had been exposed to fluoridated water over their entire lifespan had dental health benefits, but those benefits were much greater for children from lower socio-economic backgrounds.
“Children fully exposed to fluoride made up 58.1 per cent of the group we analysed, and we found they were more likely to have higher household socio-economic status, lower area-level socioeconomic disadvantage, better dental health and private dental insurance,” Dr Matsuyama said.
“But when looking at the actual benefits of fluoridated water, we found that the group to have the most benefits were more likely to be children from single-parent households, with lower household income, have parents not working, and live in socio-economically disadvantaged areas.”
Professor Do said these results confirmed the universal impact of water fluoridation for everyone in the communities, regardless of their conditions and abilities.
Queensland Health’s Statewide Oral Health Services Plan (SOHSP) acknowledges that the burden of disease & access to fluoridated water is among several oral health service challenges. The plan identifies priority populations which include people living in rural and remote areas and First Nations people specifically. SOHSP includes that targeted interventions are required in areas of Queensland without fluoridated water. SOHSP first Service Direction Action is 1.1 Promote the benefits of water fluoridation as a safe and effective public health intervention for maintaining good oral health.
Agency for the 2008 Water Fluoridation Act falls under Queensland Health with oversight by the Health Protection Branch. Under this legislation, local governments (LGs) in Queensland can decide to add fluoride if satisfied the decision is in the best interest of the community.
Cairns Regional Council is the largest drinking water supplier in Australia that does not provide fluoridated water due to repeated decisions against the advice of Queensland Health. Cairns Regional Council’s recently reaffirmed position includes that oral health is the responsibility of the state government and a lack of community consensus despite its legislated responsibility for this decision and a majority of support in its 2016 & 2024 community surveys on this public health measure.
There are over one million Queenslanders represented by 44 LGs with over 1000 residents who have decided that that fluoridation is not in the best interests of their communities, despite Queensland Health’s ongoing support and various peak public health bodies advocating for wider access to fluoridated water. This is over 20% of Queenslanders and includes over 41% of the Aboriginal and Torres Strait Islanders of Queensland. This is leading to an increased burden of oral health disease in these communities compared to areas with fluoridated water.