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Int J Occup Environ Health. 2015;21(2):91-120. doi: 10.1179/2049396714Y.0000000093. Epub 2014 Dec 3.

A critique of recent economic evaluations of community water fluoridation.

Abstract

BACKGROUND:

Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.

OBJECTIVE:

To examine the reported cost-effectiveness of CWF.

METHODS:

Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.

RESULTS:

Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.

CONCLUSIONS:

Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.

KEYWORDS:

Caries prevention,; Cost benefit,; Cost effectiveness,; Cost of water fluoridation,; Dental fluorosis; Economic evaluation,; Effectiveness in adults,; Water fluoridation,

PMID:
25471729
PMCID:
PMC4457131
DOI:
10.1179/2049396714Y.0000000093
[Indexed for MEDLINE]
Free PMC Article

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