Te Tai Tokerau children finishing primary school have the worst tooth decay in the country. But the Far North mayor says the new compulsory fluoridation order is mystifying him and happening too fast – and he still did not know how his council would pay for it.

Northland has the worst tooth decay in the country.
Photo: Alexia Russell

There are no council-fluoridated water supplies in Northland, and the Ministry of Health’s statistics show it.

In 2020, an estimated 60 percent of children had tooth decay by Year 8.

For Māori it was nearly 70 percent.

Both figures were worse than any other district health board.

Dr Amanda Johnston is one of Northland’s dentists, who welcomed the compulsory orders last month telling 14 councils, including the Far North District Council and Whangārei, to fluoridate some drinking water supplies.

She told RNZ: “Children that aren’t able to brush their teeth with fluoride toothpaste, or have poor oral health, oral hygiene, are much more likely to get decay in their teeth. So they get pain, they get difficulty concentrating and difficulty eating and they’re kept awake at night.

“They have to have their teeth extracted under general anaesthetic commonly if they’re young children.”

Johnston, the president-elect of the New Zealand Dental Association, said paying for fluoride toothpaste wasn’t always possible for households in a region with some of most extreme deprivation in Aotearoa.

“And they can’t always afford to seek dental treatment, so they get no protection of their teeth from fluoride.”

But fluoridation hasn’t gone down well with some local government leaders receiving the letters with written orders.

Whangārei mayor Sheryl Mai has long been opposed to compulsory fluoridation of the city’s drinking water.

And today, Far North district councillors received a report, about their order to fluoridate the Kaitāia and Kerikeri supplies by June 2024.

The Far North council has received a report from the Ministry of Health about fluoridation requirements.
Photo: RNZ / Sam Olley

In the district, more than half of adults have had at least one tooth removed due to decay, infection or gum disease, according to New Zealand Health Survey data.

John Carter
Photo: Northern Advocate / Diane Stoppard

But mayor John Carter did not see the need for hurry around the health order. The council asked the government last month for an extra one to two years to prepare.

“I don’t understand why the sudden rush, [it] mystifies me,” he told RNZ today.

It will cost $800,000 to set up fluoridation in the Far North and $100,000 every year thereafter.

He said the council didn’t have spare money for fluoridation in its Long-Term Plan.

“You don’t just come along and chuck a bit of chemical in a bloody water reservoir and it all works.”

The fluoridation level ordered was between 0.7 and 1 part per million and was widely proven as safe for consumption.

Ministry working with mayor, officials in Far North

The Ministry of Health has said it was setting up an $11.3 million funding pool to help councils with the costs.

In a statement this afternoon, it said: “Fluoridation is proven to be a safe, affordable and effective method of preventing tooth decay.

“It benefits everyone, but especially children, Māori, Pacific and our most vulnerable. Unfortunately, New Zealand has high rates of preventable tooth decay, with very significant inequalities.

“The Ministry of Health [and World Health Organisation] recommends adjusting fluoride levels to between 0.7 and 1.0 ppm in drinking water as the most effective and efficient way of preventing dental decay.”

The ministry said it was finalising details for the $11.3m fund.

“An official from the Ministry of Health spoke to the mayor of the Far North District Council on 27 July 2022 after the direction to fluoridate was issued.

“An official from the Ministry of Health has also made contact with Far North District Council staff to answer any questions and to advise that further information on accessing the funding will follow.”