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A critique of recent economic evaluations of community water fluoridation

A critique of recent economic evaluations of community water fluoridation

International Journal of Occupational and Environmental Health | By Lee Ko and Kathleen M. Thiessen| December 9, 2014

Posted on December 9, 2014 United States, National USA United States
flouridationflourideFluoridationfluoride

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.

Published online: 3 Dec 2014

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