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.