Water fluoridation in Australia

Australia is one of many countries that have water fluoridation programs currently operating (see Water fluoridation by country). As of March 2012, artificially fluoridated drinking water is administered to 70% or more of the population in all states and territories. The acceptance of the benefits of water fluoridation occurred in Australia in December 1953, roughly two years after acceptance in the United States. Many of Australia's drinking water supplies subsequently began fluoridation in the 1960s and 1970s. By 1984 almost 66% of the Australian population had fluoridated drinking water, represented by 850 towns and cities. Some areas within Australia have natural fluoride levels in the groundwater, which was estimated in 1991 to provide drinking water to approximately 0.9% of the population. A key difference between the implementation of drinking water fluoridation in the United States and Australia was the impact of temperature and climate on water consumption. Temperatures are a key factor in the establishment of legislative requirements, such as the Water Fluoridation Regulation 2020 in Queensland, that prescribes concentrations of fluoride to be added to the water. Consequently, areas with higher average temperatures require less fluoride to be added to the drinking water to achieve the same oral health benefits. The tropical conditions found in parts of Australia, such as Queensland, also make it difficult to maintain fluoridation equipment due to higher levels of corrosion caused by the wet climate. The addition of fluoride to a drinking water supply is generally governed by the Australian Drinking Water Guidelines. The Guidelines recommend a health-related guideline value (maximum concentration) of 1.5 mg/L for fluoride, which mirrors the World Health Organization Guidelines for Drinking Water Quality 2006. Guidance on the concentration of fluoride has been present in the Guidelines since 1983. The National Health and Medical Research Council of Australia (NHMRC) issued a Public Statement in 2017 on Water Fluoridation and Human Health in Australia. The statement says “There is reliable evidence that community water fluoridation helps to prevent tooth decay. The consequences of tooth decay are considerable: dental pain, concern about appearance, costs due to time off school and work, and costs of dental treatment. There is no reliable evidence of an association between community water fluoridation at current Australian levels and any health problems.”

Australian Capital Territory Fluoride was initially recommended to be added to the Canberra water supply in December 1961 by the ACT Advisory Council, however the recommendation was not accepted. The ACT Advisory Body continued to lobby the government and fluoridation of the water supplies in Canberra and the City of Queanbeyan commenced in May 1964. Queanbeyan, while in New South Wales shares its water supply with Canberra. There was a brief period in 1989 where fluoridation was suspended following a formal review of the effectiveness of fluoridation on oral health. As only one water supplier provides all of the water for these areas, the percentage of the population with fluoridated water has always been 100% during the times in which it was added.

New South Wales The use of fluoride in New South Wales (NSW) is regulated by the Fluoridation of Public Water Supplies Act 1957, and the Fluoridation of Public Water Supplies Regulation 2022. The legislation constitutes the Fluoridation of Public Water Supplies Advisory Committee and prescribes its membership under section 4 of the Act. As of April 2025, it is currently chaired by the NSW Chief Dentist who was nominated by the Minister for Health, along with five other members representing health and local government agencies. Under the Act and regulations the local area council must make a request to the NSW Health Department that their water supplies be fluoridated. However, subsequent to that, if a council wishes to discontinue fluoridation then that decision rests with the Secretary of the Department of Health (Section 6B Discontinuance of Fluoridation). Approximately 93% of the NSW population has fluoridated water as of February 2017. Fluoridation commenced in New South Wales with Yass in 1956. Sydney began fluoridation in 1968. One of the earliest locations to receive fluoridation was Grafton in 1964. However, the night before fluoridation was to commence the equipment was blown up. The equipment was reinstalled and Grafton has fluoridated water. Fluoridation has not been implemented by some council areas and water utilities that service multiple council areas. They include: Hilltops Council, Brewarrina Shire, Byron Shire, Carrathool Shire, Central Darling Shire, Coonamble Shire, Gunnedah Shire, Gwydir Shire, Liverpool Plains Shire, Murrumbidgee Council, Narrabri Shire, Narrandera Shire, Narromine Shire, Upper Hunter Shire, Murray River Council, Walgett Shire and Wentworth Shire. Narrabri Shire, Narrandera Shire, Narromine Shire have naturally occurring levels of fluoride and do not supplement their water supplies. In 2018, Bega Valley Shire council voted 6 to 2 to add fluoride the areas that were not fluoridated. Oberon Council voted 5 to 3 to add fluoride to the local water supply in July 2018 and the instrument of approval was issued in October 2018. Liverpool Plains Shire council has been considering fluoridation of its water supply since 2018. In November 2013, Byron Shire Council decided to not add fluoride to its water supply.

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