Local Government oral health advocacy for Victorian communities with limited access to fluoride in 2025

<p dir="ltr">This report, developed by the Victorian Oral Health Alliance (VOHA), outlines a strategic advocacy project aimed at improving oral health in communities at highest risk of oral disease across Victoria, in rural, socioeconomically disadvantaged, and non-fluoridated areas. Despite overwhelming evidence supporting community water fluoridation (CWF) as a safe, effective, and equitable public health intervention, ~10% of regional and rural Victorians remain without access to fluoridated water. These populations are disproportionately affected by dental disease, with significantly higher rates of early childhood caries, preventable dental related hospitalisations, and delayed access to care.</p><p dir="ltr">This project aligns with the Victorian Action Plan to Prevent Oral Disease (VAPPOD) and the National Oral Health Plan (NOHP) 2015–2024, both of which prioritise water fluoridation as a core public health strategy to reduce oral health inequities. The Victorian Government has committed to increasing fluoridation coverage to regional and rural Victorians from 87% to 95% by 2030 through the VAPPOD goals; however, there is currently no funded pipeline to support water fluoridation implementation in rural and regional areas. In response, VOHA developed and implemented a targeted advocacy campaign between late 2024 and early 2025 to engage ten priority Local Government Areas (LGAs) with the largest non-fluoridated populations. These LGAs were selected based on population size, socio-economic disadvantage, and rurality measured by Modified Monash Model (MMM) scores. The campaign focused on raising awareness among local government officers, encouraging the inclusion of oral health priorities, particularly fluoridation, during the review stage of their Municipal Public Health and Wellbeing Plans (MPHWPs), and promoting alternative fluoride strategies where water fluoridation was not available.</p><p dir="ltr">Key components of the project included:</p><p dir="ltr">» Development of a tailored LGA engagement guide (supported by the Victorian Department of Health’s LGA Action Guide and Local Oral Health Profiles) with evidence-based messaging</p><p dir="ltr">» Coordination of meetings with LGA staff, resulting in engagement from 7 of 10 target LGAs</p><p dir="ltr">» Provision of suggested MPHWP wording, oral health promotion materials, and fluoride advocacy tools</p><p dir="ltr">» Advocacy for Maternal and Child Health (MCH) nurse training, improving uptake of the Child Dental Benefits Schedule (CDBS), removal of sugary drink vending machines in public venues, and community education about fluoride.</p><p dir="ltr">Despite facing barriers such as limited funding, anti-fluoridation sentiment, and siloed local government structures, the project demonstrated strong receptivity from LGA staff and a willingness to incorporate oral health into strategic planning. The report concludes with recommendations for ongoing engagement, monitoring of MPHWP implementation post-July 2025, and expanded collaboration with other stakeholders such as VicHealth, Public Health Units (PHUs), and the Municipal Association of Victoria (MAV). Ultimately, this project represents a critical step toward achieving equitable oral health outcomes across Victoria. It reinforces the importance of strategic advocacy, intersectoral collaboration, and systems-level support to ensure that all Victorians, regardless of geography, benefit from the preventive power of fluoride.</p>