Water fluoridation and human health in Australia

Community water fluoridation is the adjustment of fluoride in drinking water to reach a level that can help to reduce tooth decay.

In Australia, community water fluoridation programs are considered a safe and effective way of reducing tooth decay across the population. Tooth decay is one of the most common health problems in Australia. It can cause pain, difficulty eating and sleeping, and may make people feel unhappy about their appearance.  In Australia, dental health has improved since water fluoridation began in the 1950s. Compared to their parents’ generation, Australians born after 1970 (when the majority of water fluoridation programs commenced in Australia) have about half the level of tooth decay.1

Along with a combination of healthy diet, good oral hygiene, appropriate use of fluoridated toothpaste and regular dental check-ups, water fluoridation is an effective public health measure to prevent tooth decay.

NHMRC has recently finished a thorough review of the latest scientific research relevant to Australia on the potential link between water fluoridation and human health. NHMRC has confirmed that community water fluoridation helps to reduce tooth decay, and that there is no reliable evidence that water fluoridation at current Australian levels causes health problems.

NHMRC 2017 Public Statement

NHMRC has released its Public Statement 2017 : Water Fluoridation and Human Health in Australia (2017 Public Statement). This contains NHMRC’s recommendation on community water fluoridation, and a range within which NHMRC supports states and territories fluoridating their drinking water supplies. It reflects the latest evidence from the review mentioned above.

The Fluoride Reference Group - a committee of health, dental and other experts, such as those with expertise in epidemiology, ethics and water management - guided this work. 

Other resources

Earlier in 2017, NHMRC released three resources from the review:

Questions and Answers Resource

NHMRC has also published Water Fluoridation and Human Health in Australia: Questions and Answers to support the release of the 2017 Public Statement. NHMRC developed this resource in consultation with state and territory health representatives to assist them to provide nationally consistent messages on water fluoridation to the public.

Key milestones

The development processes and activities for the review are summarised below and detailed in the Administrative Report.

1. Assessing the evidence and developing the Information Paper

Fluoride Reference Group established May 2014

Public call for evidence

  • In this call for evidence the Australian community was invited to submit published studies to be evaluated as part of the evidence evaluation, namely for the systematic review on other health effects (excluding dental effects). Non-confidential submissions are available on the NHMRC Public Consultations website.
23 July – 22 August 2014
Evidence evaluation completed Early 2016

Drafting of the Information Paper – Water fluoridation: dental and other human health outcomes

  • This paper summarise the findings of the evidence evaluation and assesses how relevant these findings are for Australia.
May – August 2016

Findings of the evidence evaluation published in:

Publication of these reports was scheduled to coincide with the start of public consultation on the draft Information Paper
14 September 2016

Public consultation on draft Information Paper

  • The Australian community was given the opportunity to participate in how NHMRC develops health advice and submit studies on the dental and other human health effects of water fluoridation. Non-confidential submissions are available on the NHMRC Public Consultations website. The release was accompanied by a news briefing.
14 September - 13 October 2016
Expert review of the Information Paper 7 February – 7 March 2017
Final Information Paper issued 4 July 2017

2. Developing a new Public Statement

Drafting of the 2017 Public Statement

November 2016 – June 2017

Public consultation on draft 2017 Public Statement

  • The Australian community was given the opportunity to participate in how NHMRC develops and disseminates its health advice, by ensuring that the Public Statement is appropriately presented and that the recommendation is clearly justified. Non-confidential submissions are available on the NHMRC Public Consultations website.
4 July  – 3 August 2017
Final 2017 Public Statement issued 9 November 2017

Historical resources

2007 NHMRC Review

In 2006, NHMRC undertook a systematic review of the evidence for the efficacy and safety of fluoride interventions. This review focused on sources that could be used to deliver fluoride to the Australian community including drinking water, milk, salt and topical fluoride treatments. The review considered possible benefits and harms of these different sources of fluoride. The full reports are A Systematic Review of the Efficacy and Safety of Fluoridation Part A and A Systematic Review of the Efficacy and Safety of Fluoridation Part B.

NHMRC’s 2016 Evidence Evaluation includes and builds on the 2007 NHMRC review.

As a result of the 2007 Systematic Review, NHMRC released the NHMRC Public Statement: The Efficacy and Safety of Fluoridation 2007 (2007 Public Statement). The 2017 Public Statement updates and replaces the 2007 Public Statement to reflect the recent evidence reviewed by NHMRC.

References

Australian Institute of Health and Welfare 2012. Australia’s Health 2012: in brief. Cat. no. AUS 157. Canberra: AIHW

Contact

For further information please contact NHMRC at fluoride@nhmrc.gov.au