- This paper is the final part of a three-part series looking at the environmental impact of different community-level caries prevention programmes.
- This paper quantifies the environmental impact of water fluoridation and compares it to results from part one (fluoride varnish application) and part two (toothbrushing programmes).
- This paper suggests how sustainability data can be used alongside clinical and cost effectiveness to make decisions about prevention at a population level.
Introduction Community-level interventions for the prevention of dental caries in children include fluoride varnish in schools, supervised toothbrushing in schools, the provision of toothbrushes and toothpaste and water fluoridation. The environmental impact of these interventions is an important factor to consider when commissioning these services.
Materials and methods A comparative life cycle assessment (LCA) was conducted to quantify the environmental impact of fluoridation of the public water supply for a five-year-old child over a one-year period. These results were compared to LCA data for fluoride varnish in schools, supervised toothbrushing and the provision of toothbrushes and toothpaste.
Results When comparing community-level caries prevention programmes, water fluoridation had the lowest environmental impact in all 16 categories and had the lowest disability-adjusted life years impact.
Discussion All community-level caries prevention programmes have an associated environmental cost. Water fluoridation performed well in this LCA study in all measures of environmental sustainability. The results of this study could be used, along with cost and clinical effectiveness data, to inform public healthcare policy.
*Original abstract online at https://www.nature.com/articles/s41415-022-4251-5