Fluoridation of New Zealand's public water supplies : an historical investigation into societal attitudes and concerns, 1950-2008

Abstract

Artificial fluoridation of public water supplies began in New Zealand in 1954 as a public health response to New Zealand's high levels of endemic tooth decay, indicating a shift in emphasis from dental health treatment to preventive dentistry. By 1980 about 50 per cent of the New Zealand population was receiving fluoridated water, and this has remained steady for the past 30 years. Since its introduction, fluoridation has been the subject of vehement debate, much of which had little to do with dental health. This thesis explores that debate; it looks in particular at the difficulties encountered by the pro-fluoridationists in instigating this dental health measure, a facet of well-being about which most people have been largely indifferent, and the strategies employed by antagonists to prevent fluoridation. Investigating fluoridation's history reveals much about New Zealand society and social attitudes in the period under discussion. To New Zealand health professionals fluoridation has always represented substantially improved dental health, particularly amongst children, as well as a major cost-saving to the public health purse. To the anti-fluoridationists it has involved much wider issues. The core of opponents' concerns has been based upon the theme of liberty and free choice. Opponents have also regarded fluoridation as the cause of a wide range of health problems, with a special emphasis on cancer from the 1970s. Their perceptions have included scepticism towards science and scientific experts, and a romantic image of the nature of water. The history of fluoridation in New Zealand challenges previously held views of a conformist mid-twentieth century society, and adds to the ongoing re-examination of women's involvement in the public sphere in the 1950s and 1960s. On the international stage, New Zealand has contributed to the work of WHO on fluoridation while, individually, some New Zealand pro- and anti-fluoridationists have played a noteworthy role in fluoridation's global history and international debates. This thesis reveals there is no victor in the debate; instead the controversy continues and changes as the fluoridation discourses are reinvented according to the latest scientific research and societal concerns. According to the New Zealand Ministry of Health, fluoridation is still needed despite marked overall improvements in dental health; others continue to question its safety and efficacy.