Community water fluoridation in Aotearoa New Zealand

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Health (Fluoridation of Drinking Water) Amendment Act 2021

Some local authorities have been fluoridating the drinking water they supply for a number of years. Approximately half of New Zealanders have access to fluoridated drinking water.

Given its well established benefits for oral health, the Health Act 1956 was amended by the Health (Fluoridation of Drinking Water) Amendment Act 2021 to enable a nationally consistent approach to community water fluoridation.

The Health (Fluoridation of Drinking Water) Amendment enables the Director-General of Health to direct local authorities to add – or not to add – fluoride to a drinking water supply. Any local authority that receives a direction to fluoridate one of its drinking water supplies must take all practicable steps to ensure the optimal level of fluoride is present in that supply.

Local authorities may also choose to start fluoridating any drinking water supplies without being directed to by the Director-General. And any local authority that was fluoridating a drinking water supply before the amendments came into effect must continue to do so.

In deciding whether to make a direction to fluoridate, the Director-General is required to consider: 

  • scientific evidence on the effectiveness of adding fluoride to drinking water in reducing the prevalence and severity of dental decay 
  • whether the benefits of adding fluoride to drinking water outweigh the costs, taking into account the oral health and size of the community as well as the financial costs including ongoing management and monitoring. 

If the Director-General were to issue directions to local authorities to fluoridate all drinking water supplies servicing populations over 500, it would result in over 80 percent of New Zealanders having access to fluoridated drinking water.

For further information on the legislative and legal framework for community water fluoridation, see: 

Directions to fluoridate

The Director-General of Health has issued 14 directions to local authorities to fluoridate community water supplies. This follows a process as described in the Health Act 1956.

The 14 local authorities that have received directions are:

Local authorities that received a direction to fluoridate in July 2022
Local authority Water supply Serviced population Compliance date
Kawerau District Council Kawerau 7,721 30 June 2023
Hastings District Council Hastings Urban 64,764 30 June 2023
Horowhenua District Council Levin 22,000 30 April 2024
New Plymouth District Council New Plymouth 66,562 Has begun fluoridating (compliance date was 31 July 2023)
Waipa District Council Cambridge 21,794 31 July 2023
Whangarei District Council Bream Bay 14,800 31 August 2024
Whangarei 56,530 30 June 2026
Rotorua Lakes Council Rotorua Central 44,000 30 April 2024
Rotorua East 13,000 30 April 2024
Nelson City Council Nelson 52,400 31 December 2024
Far North District Council Kaitaia 5,400 30 June 2024
Kerikeri 6,700 30 June 2024
Auckland Council Onehunga 25,507 30 June 2024
Waiuku 8,697 30 June 2026
Tararua District Council Dannevirke 6,000 30 June 2024
Waitaki District Council Oamaru 15,561 30 June 2024
Tauranga City Council Tauranga 153,500 31 July 2024
Western Bay of Plenty District Council Athenree 5,125 31 July 2025
Wharawhara 5,700 31 July 2025

Manatū Hauora is supporting local authorities that received a direction in July 2022 with funding for capital works. The compliance dates vary and are based on information provided by local authorities. 

For further details, see the information provided to the Director-General to inform decision-making on these drinking water supplies.

A recent High Court judgment found that the Director-General of Health made an error of law by not explicitly considering the rights under the New Zealand Bill of Rights Act 1990 in making a decision on each direction. The Judge directed the Director-General of Health to assess whether each of the directions for local authorities is a demonstrably justified limit on the right of persons in those districts to refuse medical treatment. That right is provided for in section 11 of the New Zealand Bill of Rights Act.

The Director-General will assess each direction as directed by the Judge. In the meantime, the Court has confirmed that each of those directions remain in place.

You can find more information at Fluoride legal decision update.

Will further directions to fluoridate drinking water be issued? 

In November 2022 the Director-General wrote to 27 local authorities to advise that they are being actively considered for a direction to fluoridate in relation to one or more of their drinking water supplies.

These water supplies remain under active consideration, however the Director-General is taking further time. This is to allow consideration of the impact of several wider factors including reform across the water services sector, and service delivery pressures across the local government sector.

Drinking water supplies currently under active consideration for a direction to fluoridate
Local authority Water supply Serviced population
Ōpōtiki District Council Ōpōtiki 4,530
Far North District Council Kaikohe 4,200
Paihia 4,000
Kawakawa/Moerewa 3,500
Omapere 900
Okaihau 800
Rawene 600
Wairoa District Council Wairoa 4,650
Rotorua Lakes District Council Ngongotaha 4,826
Hamurana/Kaharoa 1,700
Reporoa 1,060
Rotoiti 880
Mamaku 868
Rotoma 500
Whakatane District Council Rangitaiki Plains 2,897
Otumahi 2,841
Murupara 1,674
Taneatua 790
Matata 690
Ruatoki 560
Kaipara District Council Dargaville 4,683
Maungaturoto 980
Taupō District Council Acacia Bay 2,381
Omori/Kuratau/Pukawa 1,883
Kinloch 1,696
Mangakino 1,312
Motuoapa 739
Ruapehu District Council Taumarunui 4,870
Ohakune 1,500
Raetihi 749
Waitomo District Council Te Kuiti 4,612
Piopio 500
South Waikato District Council Putaruru 4,116
Tirau 700
Horowhenua District Council Foxton 2,700
Foxton Beach 1,900
Shannon 1,436
Tokomaru 550
Whanganui District Council Whanganui 39,775
Rangitikei District Council Marton 4,764
Taihape 1,584
Bulls 1,419
Western Bay of Plenty District Council Muttons 8,550
Pongakawa 4,850
Ohouere 2,250
Youngson Road 8,480
Tahawai (linked with Athenree) 7,240
Waihi Beach (linked with Athenree)
Tararua District Council Pahiatua 2,700
Woodville 1,500
Hauraki District Council Waihi 4,927
Paeroa 4,887
Kerepehi 2,552
Waitakaruru 2,076
Hastings District Council Haumoana / Te Awanga 1,900
Whirinaki – Hawkes Bay 800
Clive 560
Waimārama 500
Hutt City Council Petone 7,491
Korokoro 1,482
Napier City Council Napier 59,055
Buller District Council Westport 4,974
Reefton 951
Westland District Council Hokitika 3,447
Franz Josef 2,611
Kaikoura District Council Kaikoura 2,500
Waimate District Council Waimate 3,000
Hook/Waituna Rural 1,350
Marlborough District Council Blenheim 24,028
Picton / Waikawa 4,185
Renwick 1,884
Awatere 1,333
Riverlands Industrial 740
Havelock 618
Seddon 535
Timaru District Council Timaru City 26,832
Temuka 4,620
Downlands – Te Ana Wai 4,550
Geraldine 2,121
Te Moana Scheme 1,650
Pleasant Point 1,200
Seadown 895
Downlands-Waitohi 700
Dunedin City Council Waikouaiti 1,642
Outram 750
Queenstown Lakes District Council Queenstown 25,271
Wānaka 13,633
Arrowtown 4,366
Hawea 3,767
Lake Hayes 3,743
Arthurs Point 1,631
Glenorchy 1,232
Luggate 855

Monitoring drinking water fluoridation levels in New Zealand

Water treatment plants are monitored regularly to ensure fluoride concentrations do not exceed the maximum acceptable value set out in the Water Services (Drinking Water Standards for New Zealand) Regulations 2022 (ie, 1.5 mg per litre). Taumata Arowai – the water services regulator – monitors compliance with the Drinking Water Standards, including for fluoride. Any exceedances must be reported to Taumata Arowai.

The Ministry is developing a monitoring process to ensure fluoride levels across New Zealand remain within the optimum range for oral health benefits (ie, 0.7–1.0 mg per litre).

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