The Strong Teeth Study; Background, rationale and feasibility of fluoridating remote Indigenous communities

The caries experience of Australian Indigenous children has deteriorated at the same time as that of non-Indigenous children has greatly improved. Fluoridating the water supplies of Indigenous communities emerged as a policy direction at the beginning of the 2000s. However, remote Indigenous communities are small, highly dispersed and isolated. This paper describes the Strong Teeth Study, a series of projects for the fluoridation of remote Indigenous communities in the Northern Territory. The background and rationale for two demonstration fluoridation projects are presented and the feasibility of operating small-scale fluoridation plant and measuring the impact on caries experience described. The demonstration fluoridation projects were commenced, but not sustained. The lessons learnt about environmental enablers and essential service requirements are highlighted. Fluoridation has the potential to improve oral health so as to contribute positively to child development as part of the broader mission of closing the gap in health between Indigenous and non-Indigenous Australians.