Water fluoridation in Australia

Water fluoridation in Australia (1964-1977 and 2012)
Amount of fluoride added to public water in ppm by postcode in Australia, 1964-1977 and 2012.[1]

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 provided for 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.[2] Many of Australia's drinking water supplies subsequently began fluoridation in the 1960s and 1970s. By 1984 almost 66% of the Australian population had access to fluoridated drinking water, represented by 850 towns and cities.[3][4] 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.[3]

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 2008[5] 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.[6] 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.[7] Guidance on the concentration of fluoride has been present in the Guidelines since 1983.

Like other countries with water fluoridation programs, Australia has organised anti-fluoride groups that contest the health benefits of fluoride. In addition to claiming that fluoride offers no health benefits whatsoever, they claim that moderate fluoride exposure can lead to reduced IQ, damaged bones, brain, kidneys and thyroid, dental fluorosis, and many more severe effects.[8]

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.”[9]

Tasmania

Fluoridation in Tasmania was initially regulated under the Public Health Act of 1953.[10] The Tasmanian Government set up a Royal Commission to look into Fluoridation in 1966 and the report was published in 1968.[11] The Royal Commission recommended that fluoridation should be a state responsibility. The Royal Commission stated that "Fluoridation must be a decision of the State Government. It is not a decision for a referendum or for local councils as people simply do not have the expertise in that. For a State Government to refer this decision off to a referendum or to local government would be an abrogation of the State's responsibility."[12]: 26:25 

The Fluoridation Act of 1968 was passed and gained royal assent in January 1969 [13] this act regulates the fluoridation of drinking water in Tasmania. Almost all (98%) all public water supplies in Tasmania are fluoridated although approximately 10% of the residents do not have access to public water supplies.[14] Under the Act, the need to add fluoride to a water supply is assessed by a fluoridation committee, which then provides a recommendation to the Health Minister. The Health Minister may then choose to direct the water authority to add fluoride to the water.

The first town in Australia to fluoridate its water supply was Beaconsfield, Tasmania in 1953.[12][15][16] It is understood that the impetus to fluoridate the water came from the Municipal chemist, Frank Grey, who was prompted to act when an opera singer advised him not to let his daughter's teeth be pulled if he wished her to continue singing. This was after a visiting dentist (to the local school) had extracted a tooth from his daughter.[16][12]: 2:07 

New South Wales

The use of fluoride in New South Wales (NSW) is regulated by the Fluoridation of Public Water Supplies Act 1957,[17] and the Fluoridation of Public Water Supplies Regulation 2007.[18] The legislation allows for the Fluoridation of Public Water Supplies Advisory Committee and prescribes its membership under section 4 of the Act. It is chaired by the NSW Chief Dentist as the Minister of Health representative.[19] 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). [17]

Approximately 95% of the NSW population has access to fluoridated water (September 2011). Fluoridation commenced in New South Wales with Yass in 1956.[20] Sydney began fluoridation in 1968.[21] 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.[22]

Fluoridation has not been implemented by some council areas and water utilities that service multiple council areas. They include: Boorowa (Hilltops), Brewarrina, Byron Shire, Carrathool, Central Darling, Coonamble, Gunnedah, Gwydir, Jerilderie, Liverpool Plains, Murrumbidgee, Narrabri, Narrandera, Narromine, Upper Hunter, Wakool, Walget, Wentworth and Water NSW. Narrabri, Narrandera, Narromine have naturally occurring levels of fluoride and do not supplement their water supplies.[23] In 2018 the Bega Shire Council voted 6 to 2 to add fluoride the areas that were unfluoridated.[12]: 22:39  [24][25] Oberon Shire Council voted 5 to 3 to add fluoride to the local water supply in July 2018[26] and the instrument of approval was issued in October 2018.[27] Liverpool Plains Shire Council has been considering fluoridation of its water supply since 2018.[28][29]

In November 2013, Byron Shire Council decided to not add fluoride to its water supply.[30] Port Macquarie Shire Council has decided to ask voters whether they should retain fluoridated water however, that decision rests with the NSW Department of Health.[31]

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.[32] Queanbeyan, while in New South Wales shares its water supply with Canberra.[33] There was a brief period in 1989 where fluoridation was suspended following a formal review of the effectiveness of fluoridation on oral health.[3] As only one water supplier provides all of the water for these areas, the percentage of the population with access to fluoridated water has always been 100% during the times in which it was added.

Western Australia

Water fluoridation in Western Australia (WA) is regulated by the Fluoridation of Public Water Supplies Act 1966.[34] The act is administered by the Western Australian Department of Health through the Fluoridation of Public Water Supplies Advisory Committee. The minister for Health can only direct water be fluoridated on the advice of the committee.[35]

Water fluoridation was introduced in Western Australia 1968.[36] As of 2016, around 92% of the population is provided with fluoridated water through a drinking water supply.[36] Western Australia has a number of areas where no additional fluoride is added to reach effective levels; these include: Halls Creek, Marble Bar, Onslow, Paraburdoo, Tom Price, Meekatharra, Carnarvon, Bremer Bay, Leonora and Laverton.[36]

The water supply in Dunsborough, in the south west of Western Australia, is de-fluoridated to the optimal level ( 0.6 to 0.9 milligram per litre). Dunsborough gets its water from two aquifers and only the Sue Aquifer has fluoride above the optimum level.[36]

South Australia

Water fluoridation in South Australia (SA) is administered through government policy rather than legislation.[16] It is the responsibility of SA Water to administer fluoridation with South Australian water Supplies. [37]In many cases water derived from bores is not fluoridated.[38]

Water fluoridation commenced in Adelaide in 1971. There is no legal requirement to add fluoride to drinking water supplies. Currently, March 2020, SA Health states that "90% of the state’s communities have access to reticulated water with appropriate levels of fluoride".[39]

Northern Territory

The addition of Fluoride to public water supplies in the Northern Territory (NT) is done via government policies.[16] In 2010 the NT Department of Health published a position paper that strongly encourages water providers to add fluoride where possible but it is not mandated. The Department of Health believes that communities with greater than 600 persons and naturally occurring fluoride of less than 0.5 mg/L should receive fluoridation based on a cost benefit analysis.[40] The fluoridation of NT water supplies is the responsibility of the Power and Water Corporation. The Power and Water Corporation supplies water to 92 locations, 7 have fluoride added to their water and 71 have sufficient natural fluoride levels.[41]

As of 2012, 70% of the population in the Northern Territory has access to fluoridated water. Approximately 9% of the population have naturally fluoridated water. Fluoride has been added to public water supplies in Darwin since 1972.[40] Katherine, Angurugu, Maningrida, Umbakumba, Wadeye and Wurruniyanga (Nguiu) also have fluoridated water. As of 2019 fourteen other areas are being considered for fluoridation.[41] Nhulunbuy, in north east Arnhem Land does not fluoridate and a review carried out in 2020 has not resolved the issue.[42] In 2019 the East Arnhem Clinical & Public Health Advisory Group sent an open letter to the Power and Water Corporation supporting water fluoridation.[43]

Supplies south of Elliott have naturally occurring fluoride at levels sufficient to provide an oral health benefit. [40] Most communities in the Barkly and Southern regions have fluoride levels between 0.5 mg/L and 1.5 mg/L. In 2017-18 three locations recorded above accepted maximum levels at Alpurrurulam (1.7mg/L), Nyirripi (1.8mg/L) and Yuelamu (1.6mg/L).[44] Concern has been raised about fluoride levels below acceptable levels in Alice Springs and Yulara.[45]

Victoria

Fluoride was first added to the drinking water for the Victorian town of Bacchus Marsh in 1962, with Melbourne beginning fluoridation in 1977. [46]The towns of Portland, Nhill, Port Fairy, Barnawartha, and Kaniva have naturally occurring fluoride in their drinking water.[47] In August 2012 approximately 90% of the Victorian population had access to fluoridated water.[48] The fluoridation of Victoria's drinking water supplies is regulated by the Health (Fluoridation) Act 1973, by the Department of Health.[49]

Queensland

Queensland residents served with community water fluoridation, 2011

In Queensland (QLD) prior to the Fluoridation of Public Water Supplies Act 1963 (Qld),[50] some councils had fluoridated town water supplied under the Local Government Acts. These Acts used general competency clauses that gave councils the ability to use discretionary powers if the action was not specifically covered by legislation.[10] Under this Fluoridation of Public Water Supplies Act 1963 (Qld) only 5% of drinking water supplies were fluoridated. Queensland was unique in that it did not pursue water fluoridation like all the other Australian States and Territories and only 7 of the 850 Australian fluoridated water supplies operating in 1984 were located in Queensland.[4] The reason for the low uptake of fluoridation in Queensland "lies with the Fluoridation of Public Water Supplies Act 1963 (Qld), which gives real power to the minister for Local Government, local authorities and 10 percent of electors, who can all request a referendum on fluoridation proposals. This law has given opponents of fluoridation tactical advantages, which they have used consistently."[10]

Under Queensland Premier Anna Bligh, the Labor government announced on 5 December 2007 that the mandatory fluoridation of most of Queensland's water supplies will begin in 2008.[51] When it was enacted the Water Fluoridation Act 2008 required the addition of fluoride to any water supply providing potable water to at least 1000 members of the public, unless an exemption is granted based on safety or naturally occurring levels that meet the required levels.[52] The Act received bipartisan support.[53] The fluoridation of drinking water supplies is regulated by Queensland Health.[54] Prior to this legislation Queensland was the only Australian state without a formal statewide program for the addition of fluoride to drinking water; unlike other states responsibility for fluoridation lies with the Minister for Local Government rather than the Minister for Health. [10]

The accompanying Water Fluoridation Regulation 2008 listed 134 drinking water supplies that were to be fluoridated by 31 December 2012. Of the drinking water supplies listed in the Regulation, 32 comprised the SEQ Water Grid located in Southeast Queensland. The fluoridation of these supplies by the end of 2009 accounted for the largest increase in people currently receiving fluoridated water in Queensland (approximately 2.6 million people in 2006 or 68% of the Queensland population).[55]

On 29 November 2012 the Queensland Parliament, with a Liberal National Party government, reversed the previous Labor government's mandate requiring certain public potable water supplies to add fluoride to the water.[56] Annastacia Palaszczuk, current Premier of Queensland (as at 2021) attacked the decision of the government at that time but later stated in 2016 that "there is no present intention of reversing the 2012 decision."[57] This decision is seen as a regional political issue taking precedence over the government's positive stance on fluoridation. [58][59]As a consequence of these changes local councils in Queensland have the choice to add fluoride to drinking water supplies, similar to the conditions in place under the previous legislation.

Five local council areas have naturally occurring fluoride in their water supplies: Bulloo Shire, Diamantina Shire, Kowanyama Aboriginal Shire, McKinlay Shire and Quilpie Shire. Both Birdsville in the Dimantina Shire[60] and Julia Creek in the McKinlay Shire[61] have naturally occurring fluoride level that exceed safe levels. Several areas of Queensland, generally in areas above the Great Artesian Basin, are known to have naturally occurring fluoride present in their drinking water, a characteristic that has been studied since the late 1920s.[62][63]

In summary, of the 77 Local Councils in Queensland, five have naturally high levels of fluoride, 26 fluoridate some or all of their water and the remainder do not fluoridate their water. In South East Queensland water is supplied to a number of council areas by SEQ Water who continue to fluoridate their water.[64] Since November 2012 the major regional centers of Cairns,[65] Mackay,[66] Rockhamption,[67] Gladstone[68] and numerous other councils[69][70][71][72] have stopped fluoridation of their water.[73]

After Mackay Shire Council decided to cease fluoridation of their water supply, Mayor Greg Williamson stated "... as a local council, public health is not our domain. We shouldn't be in this situation, but we are, so we made a decision."[66] While Councilor Manning from the Cairns Shire Council stated "“It is also clear that fluoride is a State issue and if you believe that children in this state have poorer oral health than others, surely it’s time for Queensland Health to take responsibility for this issue as it does for other public health matters."[74]

References

  1. ↑ "Dental Practice Education Research Unit at The University of Adelaide". www.adelaide.edu.au. Retrieved 2 March 2018.
  2. ↑ "Water Fluoridation: The Engineers' Contribution" (PDF). Retrieved 12 January 2018.
  3. 1 2 3 "Inquiry into Water Fluoridation in the ACT - Report by the Standing Committee on Social Policy, 1991" (PDF). Archived from the original (PDF) on 26 March 2012. Retrieved 12 January 2018.
  4. 1 2 Commonwealth Department of Health, Fluoridation of Water: A Collection. 9; Commonwealth Department of Health, Fluoridation of Water in Australia 1984 (Canberra: Australian Government Publishing Service, 1985), 13.
  5. ↑ Water Fluoridation Regulation 2008. "In force legislation - Queensland Legislation - Queensland Government" (PDF). www.legislation.qld.gov.au. Retrieved 12 January 2018.
  6. ↑ "Australian Drinking Water Guidelines 2011". National Health and Medical Research Council. 2011. Retrieved 28 August 2012.
  7. ↑ "WHO | Guidelines for drinking-water quality, fourth edition". WHO. Archived from the original on 7 July 2011. Retrieved 21 February 2021.
  8. ↑ Bryson, C. (2004). The Fluoride Deception. New York: Seven Stories Press.
  9. ↑ NHMRC Public Statement 2017 (2017). "Water Fluoridation and Human Health in Australia". NHMRC. {{cite web}}: |last= has generic name (help)
  10. 1 2 3 4 "Water Fluoridation in Queensland, Why Not? Timing, Circumstance, and the Nature of The Fluoridation of Public Water Supplies Act (1963)" (PDF). university of Queensland. 2006. Retrieved 18 February 2021.
  11. ↑ Crisp, Peter (1968). Report of the Royal Commissioner into the Fluoridation of Public Water Supplies (. Hobart, Tasmania: Tasmanian Parliament-Government Printer.
  12. 1 2 3 4 "Something in the water — the bitter struggle over fluoride in Australia". The History Listen.
  13. ↑ "The Fluoridation Act 1968". www.legislation.tas.gov.au. Retrieved 13 January 2020.
  14. ↑ "Fluoridation of Drinking Water". www.dhhs.tas.gov.au. Retrieved 14 January 2020.
  15. ↑ Graham Aplin, S.G. Foster and Michael McKernan, ed. (1987). "Tasmania". Australians:Events and Places. Sydney, NSW, Australia: Fairfax, Syme & Weldon Associates. p. 366. ISBN 0-521-34073-X.
  16. 1 2 3 4 National Museum of Australia. "National Museum of Australia - Introduction of fluoride". www.nma.gov.au. Retrieved 11 February 2021.
  17. 1 2 "Fluoridation of Public Water Supplies Act 1957". NSW Government. 6 February 2021. Retrieved 6 February 2021.
  18. ↑ "Fluoridation of Public Water Supplies Regulation 2017". 11 August 2017. Retrieved 6 February 2021.
  19. ↑ "Fluoridation of Public Water Supplies Advisory Committee - Water quality". www.health.nsw.gov.au. Retrieved 11 February 2021.
  20. ↑ Sivaneswaran, Shanti (2012). "The revival of water fluoridation in the state of New South Wales, Australia, in the 21st century". Community Dentistry and Oral Epidemiology. 40 (s2): 65–70. doi:10.1111/j.1600-0528.2012.00722.x. ISSN 1600-0528. PMID 22998307.
  21. ↑ "New South Wales Code of Practice for Fluoridation of Public Water Supplies" (PDF). NSW Government, Department of Health. April 2018.
  22. ↑ "Bombs, brawls and bloodshed: The fight against fluoride in Grafton". www.abc.net.au. 31 July 2019. Retrieved 6 February 2021.
  23. ↑ "Fluoridation of Public Water Supplies Advisory Committee Meeting 10-2015 –Minutes" (PDF). NSW Government, Department of Health. October 2015. Retrieved 11 February 2021.
  24. ↑ Campbell, Ian. "Bega Valley Shire Council votes for fluoride". The RiotACT. Retrieved 11 February 2021.
  25. ↑ Bega Valley Shire Council, N. S. W. (2018). "Fluoride question resolved". begavalley.nsw.gov.au. Retrieved 11 February 2021.
  26. ↑ "NSW council becomes one of the last to choose fluoridation". www.abc.net.au. 18 July 2018. Retrieved 11 February 2021.
  27. ↑ Oberon Shire Council (8 October 2018). "Addition of Fluoride to Oberon Reticulated Water Supply". www.oberon.nsw.gov.au. Retrieved 11 February 2021.
  28. ↑ The Northern Daily Leader (15 June 2018). "LPSC considers fluoride for water; but will it divide the community?". The Northern Daily Leader. Retrieved 11 February 2021.
  29. ↑ Liverpool Plains Shire Council. "Health Minister urges consideration of fluoridation for public water supplies". www.lpsc.nsw.gov.au. Retrieved 11 February 2021.
  30. ↑ "Byron Shire Council decides not to fluoridate its water supply". Australian Broadcasting Corporation.
  31. ↑ "Minister warns local council about reviving the fluoridation debate". www.abc.net.au. 7 February 2021. Retrieved 11 February 2021.
  32. ↑ ArchivesACT (3 October 2020). "Councils of the past: not just roads, rates and rubbish". The Canberra Times. Retrieved 21 February 2021.
  33. ↑ "About Us | Icon Water". www.iconwater.com.au. Retrieved 21 February 2021.
  34. ↑ "Western Australian Legislation - Fluoridation of Public Water Supplies Act 1966". www.legislation.wa.gov.au. Retrieved 28 March 2020.
  35. ↑ "Fluoridation". ww2.health.wa.gov.au. Retrieved 28 March 2020.
  36. 1 2 3 4 "Fluoride facts for Western Australia". healthywa.wa.gov.au. Retrieved 28 March 2020.
  37. ↑ SA Water, Department of Water. "Fluoride". www.sawater.com.au. Retrieved 21 February 2021.
  38. ↑ "Country Drinking Water Water Supply Systems Sources and Treatment" (PDF). SA Water. 2017. Retrieved 28 March 2020.
  39. ↑ Department for Health and Wellbeing (2021). "Fluoride in water". www.sahealth.sa.gov.au. Retrieved 21 February 2021.
  40. 1 2 3 "Position Statement - The use of Fluorides in the Northern Territory" (PDF). NT Department of Health. 2010.
  41. 1 2 "Legislative Assembly of the NT, Written Question, Fluoride in the Water" (PDF). NT Parliament. 2019. Retrieved 20 February 2021.
  42. ↑ "Water Fluoridation in Nhulunbuy, Consultation Report" (PDF). Nhulunbuy Corporation Limited. 2020.
  43. ↑ "Water Fluoridation in East Arnham Communities, An open letter". Public Health Association Australia. Retrieved 20 February 2021.
  44. ↑ "Drinking Water Quality Report" (PDF). Power and Water Corporation. 2018. Retrieved 20 February 2021.
  45. ↑ "Low fluoridation of Alice Springs water called to account for rise of tooth decay". www.abc.net.au. 1 November 2018. Retrieved 20 February 2021.
  46. ↑ Neil, Dr Andrew; Dedman, Rodney (2008). "Water Fluoridation in Victoria, 71st Annual Water Industry Engineers and Operators' Conference, Bendigo" (PDF). Water Industry Operators Association of Australia (WIOA). Retrieved 21 February 2021.
  47. ↑ Department of Health & Human Services. "Water fluoridation". www2.health.vic.gov.au. Retrieved 21 February 2021.
  48. ↑ Department of Health & Human Services. "Is my water fluoridated? Location of fluoridated water in Victoria". www2.health.vic.gov.au. Retrieved 21 February 2021.
  49. ↑ "Health Fluoridation Act 1973". www.legislation.vic.gov.au. 1973. Retrieved 21 February 2021.
  50. ↑ Public Water Supplies Act 1963. "Repealed legislation - Queensland Legislation - Queensland Government". www.legislation.qld.gov.au. Retrieved 12 January 2018.
  51. ↑ "Qld to get fluoridated water". 5 December 2007. Retrieved 12 January 2018.
  52. ↑ "Water Fluoridation Act 2008". Queensland Government. 2008. Retrieved 18 February 2021.
  53. ↑ "Hansard, Water Fluoridation Bill, Second Reading (pp 749-767)" (PDF). 12 March 2008.
  54. ↑ "Fluoride - Queensland Health". www.health.qld.gov.au. Retrieved 12 January 2018.
  55. ↑ "Water Fluoridation Regulation 2008". Queensland Government. 2008.
  56. ↑ "Water Fluoridation Amendment Regulation (No. 1) 2012". 2012. Retrieved 18 February 2021.
  57. ↑ "Toothless tiger: Why Queensland is abandoning fluoride". NewsComAu. 2 October 2016. Retrieved 18 February 2021.
  58. ↑ "Fluoride coverage drops to 79 per cent of Queensland population". www.abc.net.au. 1 September 2015. Retrieved 18 February 2021.
  59. ↑ "Water fluoridation". www.health.qld.gov.au. 2019. Retrieved 18 February 2021.
  60. ↑ "Diamantina Shire Council, Drinking Water Quality Management Plan Report". Diamantina Shire Council. 2019. Retrieved 19 February 2021.
  61. ↑ McKinlay Shire Council. "Water and Sewerage". McKinlay Shire Council. Retrieved 19 February 2021.
  62. ↑ Parkinson, C.E.; et al. (1947), Interim Report of the Fluoride in Waters Survey Committee, Brisbane: Queensland Department of Agriculture and Stock
  63. ↑ Akers, H. F.; Porter, S. a. T. (2004). "An historical perspective on early progress of Queensland water fluoridation 1945–1954: Sheep, climate and sugar". Australian Dental Journal. 49 (2): 61–66. doi:10.1111/j.1834-7819.2004.tb00051.x. ISSN 1834-7819. PMID 15293815.
  64. ↑ Seqwater. "Fact sheet - Fluoridation of water supplies". Retrieved 21 February 2021.
  65. ↑ "Cairns council votes to dump fluoride - 9News". www.9news.com.au. Retrieved 21 February 2021.
  66. 1 2 Mortimer, Luke. "Mackay votes to remove fluoride: how your councillors voted". Daily Mercury. Retrieved 19 February 2021.
  67. ↑ Gately, Michelle. "Dentist bites back at Rocky council over water fluoridation". Morning Bulletin. Retrieved 19 February 2021.
  68. ↑ Gladstone Regional Council (9 July 2016). "Fluoride Position - July 2016". Retrieved 21 February 2021.
  69. ↑ "Fluoridation of Fraser Coast water will stop on Thursday". Fraser Coast Chronicle. Retrieved 19 February 2021.
  70. ↑ "Hinchinbrook Shire Council voted 4-3 to stop fluoridation – Crescent City Times.com". Retrieved 19 February 2021.
  71. ↑ "FINALLY: Council votes against fluoride". The North West Star. 14 August 2013. Retrieved 19 February 2021.
  72. ↑ "Flouride To Stay Out". southburnett.com.au. 12 March 2015. Retrieved 19 February 2021.
  73. ↑ "Fluoride coverage drops to 79 per cent of Queensland population". www.abc.net.au. 1 September 2015. Retrieved 19 February 2021.
  74. ↑ "Council makes clear decision against fluoride | Tropic Now - Cairns News". www.tropicnow.com.au. Retrieved 19 February 2021.
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