Dentists are demanding urgent action after another western New South Wales town lost access to fluoridated tap water due to broken equipment.
Last week a broken pump saw Wellington join several other towns, including Dubbo and those in the Warrumbungle and Cabonne shires, that no longer have fluoride in their water supply.
In August, Dubbo Regional Council revealed that residents had been unwittingly drinking tap water without fluoride since January 2019.
On Tuesday, the council said it had fixed Wellington's fluoride equipment, but other towns have gone without it for extended periods.
Cabonne Mayor Kevin Beatty said "skills shortages" had led to delays since 2011 in equipment upgrades in his shire, which included Molong.
Meanwhile, design faults have been blamed for the Baradine and Binnaway water treatment plants losing fluoride in 2017, and Coonabarabran's in 2015.
Dubbo dentist Sophie Halpin said it was shocking to see so many regional Australians going without fluoride for such a long time.
"With prolonged lack of water fluoridation, particularly for residents of Dubbo who did not know they had a lack of water fluoridation, we'd expect at this stage to see declining oral health outcomes and increased decay rates," Dr Halpin said.
"We do see the increased decay rate day to day … I'll be really interested to see the figures in coming years."
NSW fluoride data out of date
NSW Health data shows 96 per cent of the state's population has access to fluoridated tap water, but that figure from 2015 included the western NSW towns that were still waiting for it to be restored.
Dubbo-based teeth whitener Chrystal O'Brien said she has also noticed her clients coming in with darker, yellower teeth since the fluoride was cut off there.
She said she also saw people with yellowing teeth come in from remote country towns that relied on bore water, which did not have added fluoride.
"We see the discolouring of the teeth due to the lack of fluoride in the water — they're tending to go yellow quicker."
Australian Dental Association NSW president Rohan Krishnan said it was another sign of a growing gap in the oral health disparities between country and metropolitan people.
The association has found that children under 10 in rural areas were about 50 per cent more likely to have dental conditions so bad that they ended up in hospital.
Dr Krishnan said fluoride was crucial to reducing rates of gum disease, decay, missing teeth, and hospitalisation.
He said it was appalling that Cabonne Shire residents had gone without fluoride in their tap water for 12 years.
"We want to see action from the council to urgently resolve the issues and get the local water supply fluoridated," Dr Krishnan said.
"Water fluoridation is oral health prevention on tap — and the residents of Molong have been waiting too long."
Mr Beatty said the council was working hard to rectify the situation but was unable to get NSW Health approval to upgrade its equipment because it did not have staff qualified to handle fluoride.
"Fluoridated water remains a priority of improving dental health in our region," the mayor said.
"But this also isn't something we want to rush and counteract by addressing one health issue and creating another if not implemented correctly."
DIY fluoride in the interim
Dr Halpin said patients who were worried about a lack of fluoride could buy extra-fluoridated toothpaste and not gargle with water after brushing.
Dubbo Regional Council mayor Mathew Dickerson said Dubbo's fluoride equipment was on track to be up and running by June 30, and that Wellington's fluoride pump was tentatively due to be replaced by mid-March.
