Introduction by Croakey: Health leaders in the Victorian regional town of Heathcote are urging the Victorian Government to allocate funding for fluoridation in their local water supply in the lead-up to the state election in November.
Water fluoridation is provided to 90 percent of Victorian residents, but despite many years of advocacy, towns like Heathcote remain without the benefits of fluoridation.
According to Associate Professor Matt Hopcraft and Peter Maine, “State Government funding remains the major barrier to implementation”.
Fluoridation of the water in Heathcote could help reduce the number of decayed, missing or filled teeth among children which is reported to be two times higher than the state average.
In a region where the average waiting time for oral healthcare is “a staggering 31.4 months”, fluoridation is a simple and cost effective solution, according to Hopcraft, CEO Australian Dental Association Victorian Branch, and Maine, Chair of Advance Heathcote Inc.
Matt Hopcraft and Peter Maine write:
Tooth decay is the leading cause of preventable hospitalisation amongst Australian children, and poor oral health is one of the strongest indicators of social disadvantage. One in three children experience dental caries (tooth decay) by the age of five to six years, highlighting the need for a population level approach to prevention.
The Victorian Branch of the Public Health Association of Australia (PHAA) noted water fluoridation amongst the top 10 initiatives that have contributed to Victoria’s public health success. Sadly, for the residents of Heathcote in rural Victoria, the benefits of water fluoridation do not extend to them.
Australia’s National Oral Health Plan 2015-24 recognises that community water fluoridation “is a cost-effective and equitable initiative that is supported by overwhelming scientific evidence”.
In their report, the PHAA showed that for every dollar spent on water fluoridation, the health system saves between $7 and $18 in avoided dental treatment costs for dental caries, amounting to $1 billion in avoided healthcare and related costs over the past 25 years in Victoria.
The National Oral Health Plan has a goal to extend access to the benefits of water fluoridation to communities with populations greater than 1,000.
Regional inequities
However, despite the demonstrated success of water fluoridation, the work to extend the benefits to regional and rural Victorians is far from complete, with approximately 10 percent of the population living in areas where they do not have access to fluoridated water.
The population of the rural Victorian town of Heathcote is 2,962 – well above the threshold indicated by the National Oral Health Plan.
Despite ongoing advocacy from local community members over nearly a decade, the local water supply remains unfluoridated and State Government funding remains the major barrier to implementation.
The recent upgrade to the Heathcote Water Quality Treatment Plant has enabled fluoridation to occur if funding can be obtained and costs have been estimated at around $920,000.
Data from Dental Health Services Victoria confirms the urgency of action at Heathcote, where the average number of decayed, missing or filled teeth among children was up to two times higher than the state average.
Special Paediatric Dentist Dr Amanda Leske, who is the Senior Dentist, Bendigo Health Community Dental Services, has lent her support to the community’s push for change. She believes that it is “especially important that emphasis is placed on community-wide prevention of dental caries in this vulnerable town with disadvantaged financial and physical access to dental services”.
Dr Leske notes that:
Bendigo Health Community Dental Services commonly treats patients from the Heathcote region who are suffering the significant consequences of tooth decay, who do not benefit from fluoridated water like their counterparts in greater Bendigo.
With more than 90 percent of Victorians currently benefitting from fluoridated water, Heathcote should no longer be expected to suffer the inequality of being denied evidence-based protection from the world’s most prevalent disease of dental caries.”
As recently noted in Croakey, access to dental services “is dependent on income, and as a result low-income groups have poor access and hence poor dental health, which affects their health more generally”.
The Australian Institute of Health and Welfare note that people living in rural areas face additional barriers to good oral health:
People living in rural areas have access to fewer dental practitioners than their city counterparts, which, coupled with longer travel times and limited transport options to services, affects the oral health care that they can receive.
People living rurally also have reduced access to fluoridated drinking water and face increased costs of healthy food choices and oral hygiene products.”
This reflects the reality at Heathcote, which is among the most disadvantaged areas in Victoria.
Limited dental care
Access to private dental care is limited, and the cost prohibitive for many local people as cost of living pressures continuing to mount. As a result, many community members have to travel around 50 kilometres to access public dental services in Bendigo. But first they have to wait.
According to the Australian Dental Association Victorian Branch, the average waiting time for dental care in the local electorate is a staggering 31.4 months.
For these reasons, the Heathcote Community Plan 2021-25, developed by and for the local community, includes an action to continue to advocate for the fluoridation of the Heathcote town water supply. This aligns with the Victorian Action Plan to Prevent Oral Disease which has a 2030 goal to increase the proportion of Victorians accessing fluoridated drinking water to 95 percent.
Local organisations Advance Heathcote Inc., Heathcote Health and the City of Greater Bendigo have written to Minister Mary-Anne Thomas calling on the Victorian Government to allocate funding for this initiative prior to the State election in November.
The Australian Dental Association Victorian Branch, National Rural Health Alliance and Victorian Oral Health Alliance have also written to the Minister outlining their support.
The evidence is overwhelming. The solution is simple and cost-effective. With such a clear case for change, we are hopeful that funding will soon be announced to make it finally happen.
Further reading
Improving equity and access to dental care: what are the policy options?
See Croakey’s extensive archive of articles on oral health.
