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The tooth hurts: Dental decay hits Victorian towns without fluoride in water

He said that once the decay reached a certain level, fillings were needed — and sometimes a tooth was beyond repair and had to be pulled.

“This is extremely traumatic for the child,” he said. “As dentists, we just hate having to pull baby teeth or send a child out of the hospital to get it there. It’s all rather tragic and extremely preventable.”

Jax has his teeth checked by local dentist Mark Knapp.Credit:Joe Armao

Mansfield’s mother, Bobbie Heath, said a lack of fluoride in the water meant she taught her 11-year-old son, Jax, thorough brushing techniques as a toddler. She only buys high fluoride toothpaste.

“You just assume that if there’s fluoride in the Melbourne water, it must be in the rural water, but that’s not the case,” Heath said.

Knapp, who has practiced dentistry since the 1970s, said an experience like tooth extraction terrifies a child at an age when dentists had to convince them of lifelong treatment and care.


“They can be traumatized for years from having a bad experience with the dentist,” he said.

Towns without fluoridated water included Mansfield, Kialla, Heathcote, Leongatha, Beechworth, Stawell and Broadford.

Water fluoridation reduces the incidence of cavities by strengthening the enamel of the teeth. Fluoride is especially important for young children because baby teeth, commonly known as deciduous teeth, are softer and more susceptible to tooth decay.

Dr. Virginia Dickson-Swift, the study’s lead researcher, said she was compelled to investigate the problem after hearing reports from distressed and frustrated rural parents about high levels of decay in their toddlers and young children.

The rural health researcher said she remembered working in public hospitals in remote areas where children were brought in for painful tooth extractions.

“It was one of the most horrible things I’ve ever seen,” she said. “The mother would cry, the child would cry, and it’s all completely preventable.”

Since then, Dickson-Swift has worked with several rural towns that have successfully campaigned to get fluoride in their drinking water, including Cohuna in northern Victoria.

“This is an equity issue,” she said. “We shouldn’t be okay with people outside of urban areas having significantly worse oral health outcomes and people living in cities.”

The state average for dental pediatric hospitalizations hovers at 6.1 percent of children, compared with 17.5 percent in cities without fluoride in the water, the study found.


Researchers found that more than 50 percent of children under age 12 living in cities with non-fluoridated water had more than the average number of decayed, missing, and filled teeth. This was most pronounced in children five and younger, with 78 percent of those children reporting more tooth decay than the state average.

Knapp said a lack of fluoride in the water also negatively impacted his elderly patients, whose teeth had been weakened by drugs that reduce saliva or the natural aging process.

In some cases, he had filled cavities in elderly patients who had not needed a cavity for 50 years.

“It’s very disappointing because we now rely on industrial strength fluoride to treat elderly patients,” he said. “It’s the kind of problem you don’t see in Melbourne, but you do see it here in Mansfield.”

Knapp said he was now advising many elderly patients to invest in high-strength fluoride toothpaste.

Despite first being introduced to Australia in the 1950s, water fluoridation has been shown to reduce tooth decay by as much as 44 percent in children and 27 percent in adolescents.

A spokesman for the Victorian Department of Health said 96 per cent of Victorians already had access to fluoridated water and the government was taking steps to increase that.

He said as part of a Victorian action plan and recently fluoridated water supplies had been installed in Camperdown, Derrinallum and Lismore.

There is also a water fluoridation plant under construction in Terang near Warrnambool which will soon supply fluoridated drinking water to Terang, Mortlake, Noorat and Glenormiston.

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