Adjusted Water Fluoridation Materializes in Australia: Obstacles and Resolution, 1945-1954

In 1945, the North American concept of adjusted water fluoridation (AWF) formally emerged in the dental literature of the Commonwealth of Australia (Australia). Unconditional endorsement and implementation did not occur for eight years. Evidence is scattered throughout archives, involved many gatekeepers and the narrative is poorly recorded. The authors used a traditional historical approach in assessing the archives. The complexity, diversity and climate-specificity of decades of multidisciplinary North American research findings meant that, in Australia, the National Health and Medical Research Council could not simply endorse AWF in chorus with North American institutions. Accordingly, the authors provide the socio-political and scientific contexts, developments, evidence, findings, motives, thought and practice relating to the delayed introduction of AWF. The constitutional and statutory backgrounds and immediate post-1945 circumstances, the lack of contemporaneous research infrastructure and the physiographic features of Australia: all impeded nationally coordinated AWF advocacy, endorsement and implementation. Unlike many other therapeutic measures, the validation and implementation of AWF in Australia required assessment, caution, delay and, eventually, regulation. Despite Sydney becoming the hub of AWF advocacy, the unforeseen and autonomous implementation of AWF at Beaconsfield (Tasmania, 1953) was due to the diligence, foresight and influence of local engineer, Frank Grey.