Abstract
BackgroundFluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people.MethodsSmall scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed.ResultsThe fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of $US11,800 per unit.ConclusionOperational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries.
Highlights
Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries
The aim of this paper is to address this gap through reporting on a study of the feasibility and costs of installation and operation of fluoridation units in two remote communities, X and Y, in the Northern Territory (NT) of Australia
Remote monitoring data from Power and Water Corporation (PWC) were intended to be used but no data from this system were available at the completion of the trial
Summary
Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. Water fluoridation has been confirmed as the most cost-effective and socially equitable way of preventing dental decay in children and adults, providing 20–40% reductions in dental caries [12,13] and a number of recent international reviews [14,15,16] support the effectiveness of water fluoridation. Socio-economically disadvantaged groups, such as those living in remote Australian Indigenous communities stand to benefit the most from public health measures such as water fluoridation [17,18,19,20,21]. A number of major recent national reports have included proposals to extend water fluoridation in rural areas of Australia [22,23,24], and Australia's National Oral Health Plan recommends roll out of fluoridation of water supplies to all Indigenous communities of over 1000 people[25]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
