Little more than half of Kiwis believe fluoridation improves dental health, and less than half are in favour of putting it in the water supply, new research shows.
Perhaps a more encouraging figure for health officials is only 10 percent of Kiwis outright deny there are any health benefits, with the rest falling into the 'don't know' camp.
Nearly 3500 adult New Zealanders were asked about their knowledge of and attitudes towards oral health. Fifty-seven percent believed fluoridation of the water supply is good for our teeth, with European/Pakeha respondents, people with higher education, over-55s and those living in higher socio-economic areas more likely to back it.
Maori and Pacific Islanders had lower levels of belief in fluoridation's effectiveness, but also less negativity towards it, with most admitting they didn't know.
"The paper indicates that although benefits from community water fluoridation are expected by a large proportion of the population, there is a lack of health literacy about community water fluoridation," says Dr Robin Whyman, clinical director of oral health services at Hawke's Bay District Health Board, and co-author of the study.
"Our conclusion from the work is that there is a need to improve health literacy about community water fluoridation and that the information provided needs to consider and address the cultural appropriateness of community water fluoridation. The information needs to be provided in a culturally appropriate context."
Despite 57 percent believing fluoridation has dental benefits, only 42 percent were 'strongly' or 'somewhat' in favour of putting it in the water.
The research also showed rather than leaving it up to local boards and councils, the public wants water fluoridation decisions made by the Ministry of Health or district health boards.
"The paper illustrates how the ongoing emotive information and anti-fluoridation scaremongering gets confused with the actual science," says Dr Rob Beaglehole, spokesperson for the New Zealand Dental Association and member of the Nelson Marlborough District Health Board.
"The paper supports the New Zealand Dental Association's view that it is unfair to put the onus on local government to make the decision about whether to fluoridate or not."
A number of New Zealand councils have in recent years flip-flopped on fluoridation. Hamilton voted to remove it in December 2012, but after a referendum in 2013 saw overwhelming support for fluoridation, later voted to bring it back.
Dental problems in New Plymouth have surged since it removed fluoride from the water supply in 2011, and the Nelson City Council has been fighting with its local health board over who should pay to fluoridate its water supply.
"This is why the New Zealand Dental Association, along with Local Government New Zealand, strongly urge the Government to modify the decision-making process so that skilled, knowledgeable health authorities rather than local government politicians are responsible for water fluoridation schemes," says Dr Beaglehole.
Nearly half of those surveyed said they didn't know if there were any health risks of water fluoridation.
The highest rates of not knowing the benefits of fluoridation were found in people with no post-high school education and no natural teeth.