The impact of changing dental needs on cost savings from fluoridation

Abstract

Background: Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Methods: Net costs were estimated as Costs (programme) minus Costs (averted caries). Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. Results: With base-case assumptions, the average annual cost savings ⁄ person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24. 15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs ⁄ person were marginal. Conclusions: Community water fluoridation remains a cost-effective preventive measure in Australia.

Water fluoridation: It really is this simple

“…These New Zealand and Australian studies detailed above are compatible with other studies which indicate cost savings from CWF in the US, [119,120] Australia, [121,122] and Quebec, Canada. [123] A modelling study on CWF in South Africa also reported that benefits of CWF would exceed costs.…”

U.S. Public Health Service Recommendation for Fluoride Concentration in Drinking Water for the Prevention of Dental Caries

“…9,30 Studies continue to find that community water fluoridation is cost saving. 21,[31][32][33] Trends in availability of fluoride sources. Community water fluoridation and fluoride toothpaste are the most common sources of non-dietary fluoride in the United States.…”

“…88 Studies in the United States and Australia also have documented the cost-effectiveness of community water fluoridation. 21,[31][32][33] Safety of fluoride additives. Unique comments (about 300) expressed concern that fluoride is a poison and an industrial waste product; standard letters noted the lack of specific data on the safety of silicofluoride compounds used by many water systems for community water fluoridation.…”

Contemporary fluid intake and dental caries in Australian children

“…[18][19][20][21] In the absence of fluoridated water, caries experience of children has increased. An Australian dental health survey conducted in 2002 reported children residing in areas where the water contained negligible fluoride had poorer dental health than those residing in optimally fluoridated areas, regardless of socio-economic 122 ª 2011 Australian Dental Association…”