New PHANZ Policy Affirms The Importance Of Community Water Fluoridation
Releasing its new policy position statement on Community Water Fluoridation, the PHANZ emphasises the strong body of international and national evidence supporting community water fluoridation as a safe and effective public health measure for preventing tooth decay in both children and adults.
'Fluoridated water protects our mokopuna, whānau and communities who might face barriers in accessing dental care' says Dr Cadence Kaumoana, Chief Executive. 'It is a simple, safe, proven and equitable approach to improve the oral health of all people in Aotearoa New Zealand.'
In Aotearoa New Zealand, tooth decay is one of the leading causes of hospital admissions for children aged 0-14 years. In 2019, there were 9,267 dental and hospital events, equating to 4.6% of all children's hospital events, and tooth decay was the most common principal diagnosis (7,161 children) from all children's hospital events.[1]For adults (aged 15 years and over), 45.0% have had one or more teeth removed in their lifetime due to tooth decay, with increased prevalence for Māori (50.3%) and people with disabilities (64.4%).2
Until relatively recently, the decision to fluoridate water supplies was determined at a local authority level. However, the introduction of the Health (Fluoridation of Drinking Water) Amendment Act 2021[ 3] enabled the Director-General of Health to direct local authorities to fluoridate drinking water supplies, creating a nationally consistent, health-focused, and evidence-based decision-making process for community water fluoridation in Aotearoa New Zealand.
In July 2022, the Director-General of Health issued directions to 14 local authorities to take practicable steps (with support from the Ministry of Health) to ensure their drinking water supplies contained optimal level of fluoride.[4] As a result of the directions to these 14 local authorities, around 400,000 more people have gained access to fluoridated community drinking water.[5]
The PHANZ notes that despite the overwhelming evidence for community water fluoridation, and the public health benefits of centralising decision-making under the Director-General of Health, opposition to this approach persists.
In February 2025, a Member's Bill from New Zealand First proposed repealing the Health (Fluoridation of Drinking Water) Amendment Act 2021.[6] Repealing this would return responsibility for fluoridation to local authorities, a system that previously led to regional inconsistencies and allowed misinformation and non-evidenced-based decisions to compromise oral health outcomes.
In response to this announcement, the Health Minister reaffirmed that the Government would maintain its current fluoride policy.7
'Oral health isn't just about teeth — it's about dignity, confidence, and basic quality of life,' says Dr Kaumoana. 'We support the Government's commitment to keep community water fluoridation at the national level. Every whānau deserves access to safe and effective oral health protection regardless of their location. This is a simple, proven way to prevent harm and reduce health inequities.'
The PHANZ also recognises that oral health is shaped by a broad range of social determinants. While our recent statement focuses on community water fluoridation, it should be understood within the wider oral health context in Aotearoa New Zealand, including the impacts of childhood poverty, food insecurity, unhealthy food environments, and the unmet demand, and barriers to access, for oral health care across the health system.
Improving oral health in Aotearoa New Zealand requires coordinated, cross-sector action, of which community water fluoridation is an important component.
• Read the full PHANZ policy position statement: PHANZ Policy Position Statement on Community Water Fluoridation
• Watch the PHANZ policy webinar supporting the release of the policy position statement. This webinar includes a brief overview of the policy position statement, followed by a presentation from oral health expert and PHANZ member Heuiwon (Chris) Han.
About the Public Health Association of New Zealand
The Public Health Association of New Zealand is a non-profit organisation dedicated to promoting health and well-being in Aotearoa. Comprising a diverse membership, including health professionals, academics, and advocates, the PHA strives to influence policies and practices that address the social determinants of health and advance equitable health outcomes. Visit www.pha.org.nz for more information on our organisation and our Council members.
Note:
1 Ministry of Health Manatū Hauora. (2021). Publicly funded hospital discharges – 1 July 2018 to 30 June 2019. Wellington: Ministry of Health. https://www.health.govt.nz/publications/publicly-funded-hospital-discharges-1 july-2018-to-30-june-2019
2 Ministry of Health Manatū Hauora. (2024). Annual data explorer 2023/24: New Zealand health survey [Data File]. https://minhealthnz.shinyapps.io/nz-health-survey-2023-24-annual-data-explorer/ 3 https://www.legislation.govt.nz/act/public/2021/0044/latest/whole.html
4 https://www.health.govt.nz/strategies-initiatives/programmes-and-initiatives/oral-health/implementation-of community-water-fluoridation
5 https://www.health.govt.nz/news/better-oral-health-outcomes-as-400000-new-zealanders-gain-access-to fluoridated-drinking-water
6 https://www.nzfirst.nz/nzf-introduces-fluoridation-referendum-bill
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
RNZ News
2 hours ago
- RNZ News
New medical school at University of Waikato boasts better cost-benefit ratio, case shows
University of Waikato. Photo: Supplied / Google Maps A new medical school at the University of Waikato has been found to have a better cost-benefit ratio than other options, although only slightly. The business case for the new school has been released, which said it would have lower operating costs than other options, and would produce a higher proportion of graduates going on to become GPs. The University of Auckland has raised concerns over some of the business case's assumptions, but the health minister insists the new school was the most effective proposal at building New Zealand's "critical" health workforce. Last week, the government confirmed it would move ahead with the Waikato school, and was confident it presented the best value for money. From 2028, students will be able to start at the four-year graduate entry programme, which is intended to boost the country's rural GP workforce. National had campaigned on establishing the school at the 2023 election, but a [ full cost-benefit analysis was required as a condition of its coalition agreement with ACT. The Ministry of Health dumped a series of documents on Friday evening, including various Cabinet papers and minutes, the cost-benefit analysis conducted by Sapere, and the Ministry's detailed business case. The business case looked at three options: increasing the intake at the existing University of Auckland and University of Otago schools, a joint rural training programme run by the two schools, and the new Waikato school. The first option was estimated to cost $10.9b over the years between 2026 and 2042, and deemed the more expensive option. The joint rural training programme was estimated to cost $10.27b over the same period, while the new school - the cheapest option - was estimated to cost $9.1b. While it had the most expensive capital costs ($236.3m) the new school's operating costs ($361.6m) were deemed to be cheaper than increasing the intake at the existing schools ($513.6m) or the joint rural training programme ($508m). The lower operating costs were due to the Waikato course being shorter, the business case said. Prior degrees were also out of scope of the business case, despite the Waikato course being a graduate-entry programme. Professor Warwick Bagg, Dean of the University of Auckland's medical school, said this meant it was not a fair comparison, as it did not take into account the total cost of education. Professor Warwick Bagg. Photo: Supplied "In order to enter a graduate programme, you need to have graduated from a degree. So that's a minimum of three years, possibly longer, but at least three years which will have been funded by the government if it's been completed in New Zealand," he said. The new school also had the most favourable cost-benefit ratio, at 1.986 (meaning for every dollar invested, the benefits were worth $1.99), compared to increasing Auckland and Otago's intake (1.495) and the joint rural training programme (1.798). Waikato was also estimated to have a much higher estimated proportion of new graduates that would go on to become GPs than the other two options. The analysis estimated 38 percent of Waikato graduates would become GPs, compared to increasing the intake at Auckland and Otago (23 percent) and the joint rural training programme (33 percent). However, this is only an assumption, based on figures from the University of Wollongong's medical school, which has been used as a model for Waikato's programme. "It offers a new model, provided by a new entrant, underpinned by proven performance in an Australian context. It offers the greatest opportunity to increase GP propensity," the business case said of the Waikato option. "Option 3's propensity to provide a pathway for GPs is a consequence of a purposeful curriculum, training environments connected to communities, and a different way of selecting students. It can do this as a new entrant medical school, whereas change in an existing academic institution may be more difficult." Bagg said the modelling seemed "experimental" and "speculative," and the Australian context was different to the New Zealand context. "There are very big incentives for rural general practice in Australia that, at least to date, haven't existed in New Zealand, and certainly not historically. That's an important market force that will change behaviour. To my way of thinking, they've used the most optimistic possible outcome that could be found to make the case for the new programme." He also said the rate of graduates from the existing universities working as GPs was "quite a lot" higher than what the business case reported, saying it about 35 percent were working as GPs eight years after graduation. The health minister is standing by the figures, saying Sapere's cost-benefit analysis drew upon information about the existing Auckland and Otago graduates, as well as from Australian universities with a similar curriculum to Waikato. Health Minister Simeon Brown . Photo: RNZ/Marika Khabazi Simeon Brown said the decision was a "game-changer" for the long-term growth of New Zealand's medical workforce. "The Waikato Medical School will offer a post-graduate medical qualification based on similar successful programmes in Australia. These programmes include a year-long primary care placement and encourage students to work in primary care settings following graduation. The selection criteria of students alongside their long-term placements in primary care will both support a higher degree of these medical students to work in primary care after graduation," he said. "The Waikato Medical School will support growth of the number of general practitioners who play a critical role in keeping people healthy in the community and in managing long-term health conditions outside of hospital settings. " Labour's tertiary education spokesperson Shanan Halbert said Otago and Auckland were clear that they would be able to produce more doctors faster, if they were funded to do so. "We've got to make sure we're comparing degree with degree, apples with apples, so to speak. Because what we're seeing, as an example, is that we're comparing degrees at different lengths already." The Green Party's tertiary education spokesperson Francisco Hernandez said the dumping of the documents on a Friday evening showed the government was not confident in the business case. "The cost benefit analysis repeats the main mistake the government has made that has made this such a flawed process - rather than engaging in good faith with Otago and Auckland, and running an open process for a new graduate programme, they have deliberately stacked the deck to produce the outcome they want," he said. "The cost benefit analysis also assumes no further cost escalations - and with the minister refusing to rule out further funding - we just don't know how deep the government's blank cheque will extend to back this flawed proposal." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Otago Daily Times
5 hours ago
- Otago Daily Times
Dead teen's family told they had to get his body back to hometown
A teenager's death from complications after surgery revealed troubling gaps in complex care across the South Island at the time, the Health and Disability Commissioner says. The 19-year-old died in 2015 in circumstances where his family never had the chance to say goodbye. In addition, within minutes of them being told the teen was 'brain dead' they were asked if they would like to donate his organs. The teen's family was also told by a social worker that it was up to them to organise transportation of their son's body back to where they lived. A complaint to the coroner was referred to the HDC. In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell found that Health NZ breached a section of the Health and Disability Services Consumers' Rights code, around gaps in information and delays associated with the air retrieval team. She was also critical of why alternative transport options had not been considered for the teen who had been taken to and from various hospitals for specialised treatment and care. Health NZ had sincerely apologised for its departure from the standard of care. Death unexpected The teen died unexpectedly after suffering complications related to a postoperative wound infection. He had undergone elective surgery at a South Island tertiary hospital for the removal of benign tumours from his nervous system. Caldwell said it was complicated by postoperative infection and meningitis which required further hospitalisations at a secondary hospital and later, another tertiary hospital. The postoperative infection was treated successfully, but the teen continued to suffer complications. He was later re-admitted to hospital with ongoing headaches and vomiting but a further lumbar puncture was not done because of concerns over how the teen was coping. A decision was made to send him back to the tertiary hospital where the initial surgery was done, to insert a shunt to drain excess fluid surrounding his brain and spinal cord. Because he was considered 'neurologically stable' and there were operational delays by the air retrieval team, a decision was made to delay the transfer for a few days. While waiting, he collapsed and had a cardiac arrest. The neurosurgeon's team rushed to the hospital where he was and administered critical care but he continued to deteriorate. He was transferred back to the tertiary hospital but certified brain dead after he arrived. Outcome linked to delayed transfer Caldwell said there was dispute as to whether he would have benefited from an earlier transfer. Caldwell acknowledged the family's concerns regarding the neurosurgical care provided but she considered that Health NZ provided him with a reasonable standard of care. She said the teen's poor outcome was attributed to the delay by the air retrieval team in transferring him. However, his care was triaged and prioritised appropriately based on the information available to the team at the time, Caldwell said. An initial referral was made at 6pm and triaged by the flight coordinator with input from a senior medical consultant. Because he was considered neurologically stable and the air retrieval team was scheduled to return from another job, a collective decision was made to depart the next morning, with an expected arrival back by early afternoon. The air retrieval team stated that this was the nature of prioritisation under a resource-constrained environment, Caldwell said. On the morning of the scheduled transfer, a further delay occurred because a flight nurse had to stand down for rest after attending an overnight retrieval. Efforts were made to contact other flight nurses and intensive care nurses who were not on the roster, but none were available. At the time, the air retrieval team had been experiencing increased demands but nurse staffing levels had not increased, Caldwell said. She said between March 2015 and March 2016, there were 60 occasions when a second retrieval had been requested but could not respond. An expert's advice was that road transfer could have been considered as an alternative option but the surgeon disagreed. He said that in his experience, moving patients by road had led to a negative outcome, because of the lack of ambulance staff and inability of the ambulances to cross boundaries between healthcare districts at the time. List of changes made since The air retrieval team had since made a comprehensive list of changes, including additional nursing staff, and has introduced improved communication and operational guidelines. Caldwell said a 'significant number of changes' to the health sector had since been made. She said the amalgamation of the 20 district health boards into Health NZ had created better service integration, sharing of resources, and communication between treating teams. Health NZ Southern and Health NZ Waitaha Canterbury districts were asked to provide a formal written apology for the breaches identified in the report. Tracy Neal, Open Justice reporter
Otago Daily Times
6 hours ago
- Otago Daily Times
Teen's death exposed gaps in South Island healthcare: HDC decision
A teenager's death from complications after surgery revealed troubling gaps in complex care across the South Island at the time, the Health and Disability Commissioner says. The 19-year-old died in 2015 in circumstances where his family never had the chance to say goodbye. In addition, within minutes of them being told the teen was 'brain dead' they were asked if they would like to donate his organs. The teen's family was also told by a social worker that it was up to them to organise transportation of their son's body back to where they lived. A complaint to the coroner was referred to the HDC. In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell found that Health NZ breached a section of the Health and Disability Services Consumers' Rights code, around gaps in information and delays associated with the air retrieval team. She was also critical of why alternative transport options had not been considered for the teen who had been taken to and from various hospitals for specialised treatment and care. Health NZ had sincerely apologised for its departure from the standard of care. Death unexpected The teen died unexpectedly after suffering complications related to a postoperative wound infection. He had undergone elective surgery at a South Island tertiary hospital for the removal of benign tumours from his nervous system. Caldwell said it was complicated by postoperative infection and meningitis which required further hospitalisations at a secondary hospital and later, another tertiary hospital. The postoperative infection was treated successfully, but the teen continued to suffer complications. He was later re-admitted to hospital with ongoing headaches and vomiting but a further lumbar puncture was not done because of concerns over how the teen was coping. A decision was made to send him back to the tertiary hospital where the initial surgery was done, to insert a shunt to drain excess fluid surrounding his brain and spinal cord. Because he was considered 'neurologically stable' and there were operational delays by the air retrieval team, a decision was made to delay the transfer for a few days. While waiting, he collapsed and had a cardiac arrest. The neurosurgeon's team rushed to the hospital where he was and administered critical care but he continued to deteriorate. He was transferred back to the tertiary hospital but certified brain dead after he arrived. Outcome linked to delayed transfer Caldwell said there was dispute as to whether he would have benefited from an earlier transfer. Caldwell acknowledged the family's concerns regarding the neurosurgical care provided but she considered that Health NZ provided him with a reasonable standard of care. She said the teen's poor outcome was attributed to the delay by the air retrieval team in transferring him. However, his care was triaged and prioritised appropriately based on the information available to the team at the time, Caldwell said. An initial referral was made at 6pm and triaged by the flight coordinator with input from a senior medical consultant. Because he was considered neurologically stable and the air retrieval team was scheduled to return from another job, a collective decision was made to depart the next morning, with an expected arrival back by early afternoon. The air retrieval team stated that this was the nature of prioritisation under a resource-constrained environment, Caldwell said. On the morning of the scheduled transfer, a further delay occurred because a flight nurse had to stand down for rest after attending an overnight retrieval. Efforts were made to contact other flight nurses and intensive care nurses who were not on the roster, but none were available. At the time, the air retrieval team had been experiencing increased demands but nurse staffing levels had not increased, Caldwell said. She said between March 2015 and March 2016, there were 60 occasions when a second retrieval had been requested but could not respond. An expert's advice was that road transfer could have been considered as an alternative option but the surgeon disagreed. He said that in his experience, moving patients by road had led to a negative outcome, because of the lack of ambulance staff and inability of the ambulances to cross boundaries between healthcare districts at the time. List of changes made since The air retrieval team had since made a comprehensive list of changes, including additional nursing staff, and has introduced improved communication and operational guidelines. Caldwell said a 'significant number of changes' to the health sector had since been made. She said the amalgamation of the 20 district health boards into Health NZ had created better service integration, sharing of resources, and communication between treating teams. Health NZ Southern and Health NZ Waitaha Canterbury districts were asked to provide a formal written apology for the breaches identified in the report. Tracy Neal, Open Justice reporter
