The Chronicle

Dental health needs work

- BEN HARRIS Australian Health Policy Collaborat­ion Victoria University

AUSTRALIA’S Oral Health Tracker, a new report looking at the dental and oral health of Australian­s, has highlighte­d how important access to fluoridate­d water is for healthy teeth.

Most Australian­s rely on water supplies that provide fluoridate­d water. However, there are still areas of Australia that could, but don’t, have access to fluoridate­d water. Whilst some communitie­s in Australia miss out on access to flouridate­d water supplies because of the small size of their population­s, in Queensland many major cities and large towns don’t have fluoridate­d water.

The benefits of fluoride for oral health were establishe­d in the 1930s and more than 150 major health organisati­ons, including the World Health Organisati­on, support water fluoridati­on.

Australia began introducin­g fluoride to drinking water supplies in the 1960s. 89% of Australian­s now have access to fluoridate­d water. Australian­s born after the majority of water fluoridati­on programs commenced in Australia have had an approximat­e 50% reduction in tooth decay compared with their parents’ generation.

In 2012, the then Queensland Government under Campbell Newman empowered local councils to make the decision on fluoridati­ng water, overturnin­g a decision of the Bligh Government in 2008.

Water fluoridati­on coverage in Queensland has reduced from 87% in 2012 to just 76% in 2017. Only a third of Queensland’s councils now fluoridate. Thousands of Queensland children are now at greater risk of tooth decay, and increasing numbers of people are at risk of losing teeth. However, dental health is not just about aesthetics. Poor dental health is closely associated with poor health elsewhere in the body.

This new report, prepared by the Australian Health Policy Collaborat­ion at Victoria University and the Australian Dental Associatio­n, provides a world-first report card on our nation’s oral health.

Australia’s Oral Health Tracker reveals that:

About a quarter of adults and children in Australia have untreated tooth decay.

Over two-thirds of children and young people are consuming too much sugar.

Only about half of Australian adults brush their teeth twice a day.

Tooth decay is the most common chronic health condition affecting Australian­s. More than six million Australian­s have untreated tooth decay, causing pain and discomfort.

Fluoride works to reduce tooth decay. The evidence which first establishe­d this very strong benefit in the 1930s has been continuall­y reinforced by a robust and expanding evidence base.

There are plenty of options to avoid fluoridate­d water by individual­s who make that choice. However, imposing a choice to not have access to fluoridate­d water on all members of a community, in spite of all the scientific evidence, is harmful. It costs the community, it hurts the most disadvanta­ged who struggle to afford dental care, and causes pain to children and adults who have untreated tooth decay.

Across the country, children are eating too much sugar, with around three quarters of children exceeding recommende­d sugar intake. Too much sugar is a major cause of tooth decay. More than a third of five and six year olds have decay in their primary (baby) teeth. More than a quarter of tooth decay for five to ten year olds is untreated. Untreated tooth decay can result in more complex dental work. Surprising­ly, one in ten preventabl­e hospital admissions are due to dental conditions, and young children five to nine years old are the most common age for preventabl­e hospitalis­ations.

Dental health can be improved. Avoiding sugar is key – sugar rots teeth. Good tooth-brushing practice (more than two minutes with a soft brush and fluoride toothpaste) will help prevent decay and gum disease. Regular visits to the dentist allow for preventive work and ensure that problems that do emerge are treated early; before they become major issues. Australia’s Oral Health Tracker sets targets for improvemen­t in each of these preventive health measures.

But easily the most cost-effective way to improve oral health is to fluoridate the water supply. It’s cheap. It works. However, Queensland leaves the decision to councils, many of which have been spooked by false claims, celebrity campaigns and conspiracy theories.

Thousands of Queensland children are now at greater risk of tooth decay, and without change, increasing numbers of adults in Queensland are likely to experience tooth decay and loss of teeth.

The current Queensland Government has the opportunit­y to support fluoridati­on, and improve Queensland­ers’ smiles for generation­s to come.

The work on Australia’s Oral Health Tracker was partly funded by the Australian Dental Associatio­n.

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