By guest blogger Hilary Graham-Smith.
Hilary is NZNO’s associate professional services manager. She has had a long career as a registered nurse working in primary health care and as a Director of Nursing in primary health care.

The debate around whether to fluoridate or not fluoridate community water supplies seems to have lost sight of why fluoridation was instigated in the first place. Instead the various factions have been caught up in battles based on pseudo-science, scare mongering and downright histrionics.

NZNO has long been a proponent of fluoridation, after careful assessment of all the research.

There is overwhelming evidence, nationally and internationally that fluoridation of community water supplies works. The NZ Oral Health Survey 2009 shows that on average New Zealand children have 40 percent less decay in areas with fluoridation compared to areas without it. Surely, that should be evidence enough.

Adding fluoride to our community water supplies is about health equity –it is about closing the gap in the oral health status of our most vulnerable children and young people.

The World Health Organisation has found that “The prevalence of oral diseases is increasing in low- and middle-income countries, and in all countries, the oral disease burden is significantly higher among poor and disadvantaged population groups”.

As a nurse, I was largely unaware of the poor oral health experienced by the children in our community. Then I got the opportunity to work on a number of oral health projects where the DHB and the PHO partnered up to fund extra services so that issues like access were addressed.

I was horrified to learn that many of our tamariki have total dental clearances – yes that is all of their teeth out – before the age of five years. In fact at that time, dental clearance was the main reason for children under five having a general anaesthetic in our region.  Imagine what it must be like as a child to have difficulty eating, to feel embarrassed about your smile, to be so ashamed of your teeth that you never laugh out loud. Imagine too what the impact is on overall health and wellbeing, on self esteem and confidence and on development  – so much more than a few fillings.

The PHO/DHB initiatives meant we could extend our reach and focus on vulnerable high need communities, teach kids and parents about cleaning their teeth and keeping the sugar to a minimum; we enrolled them with the school dental service so that they would continue to get their teeth checked regularly and we lobbied hard for the community water supply to be fluoridated – and we won.

I can’t believe that we are having this debate all over again when we have such good evidence that fluoridation really does make a difference to whether or not kids experience pain, infection and tooth decay.

The data is very clear; inequalities in oral health status are consistent between children in fluoridated and non-fluoridated areas.

The evidence that fluoride is a safe and effective starting point to address these inequalities is also very clear.

As nurses we are all about evidence based practice – let’s put the evidence into practice and push for universal fluoridation  of our community water supplies.