New PHANZ Policy Affirms The Importance Of Community Water Fluoridation

The Public Health Association of New Zealand (PHANZ) supports community water fluoridation as a critical public health measure and supports the Government continuing to uphold its responsibility for implementing 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

7 https://www.rnz.co.nz/news/political/541548/fluoride-policy-won-t-change-health-minister

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