Qualitative investigation of the reasons behind opposition to water fluoridation in regional NSW, Australia

Abstract

Objectives: To investigate reasons behind strong opposition to water fluoridation in regional New South Wales, Australia, and to make recommendations to improve community engagement. Importance: Few studies have used qualitative methodologies to understand the reasons for strong antifluoridation views. An understanding of these reasons could be useful when designing public campaigns to combat the strong antifluoridation message. Methods: The qualitative study used semistructured interviewing and thematic analysis. Ten participants were recruited using purposive and snowball sampling methods until data saturation was reached. Thematic analysis and graphical representation of themes assisted in analysing the data for logical connections and relationships. Results: Six dominant themes and numerous subthemes were identified. Five of the major themes were reasons for opposition: scepticism, health effects, ethics, environmental impacts and economics. Each of these was inextricably linked to a sixth major theme: alternatives to fluoridation. Conclusions: All participants had strongly held antifluoridation views, and provided a unique insight into their perceptions and reasons for opposing water fluoridation. Concerns about ‘fraudulent research’ and the influence of industry on government bodies were novel themes. The concerns raised could be used to inform future population health campaigns, research, public education and resource-allocation decisions. Open community consultation may be able to address the issues raised in a nonjudgemental and collaborative manner.

Keywords

• oral and dental health
• prevention