US Community Preventive Services Task Force updates cost benefits evidence (2016 review)

An updated review of the cost effectiveness of water fluoridation was published in 2016 by the US Community Preventive Services Task Force (1).

Following an evaluation of six studies published between 2001 and 2013, the Task Force  concluded that the economic benefits of this public health measure outweigh the costs of installing and operating the plant and equipment required to adjust water fluoride levels to the optimum for oral health.

Costs: The average per capita annual cost of community water fluoridation was found to range from 0.11 US dollars to 4.92 US dollars, the difference being mainly attributable to the sizes of the populations served by the schemes in question.  Broadly speaking, the Task Force determined that as the population covered by community water fluoridation increases, per capita annual cost decreases.  In particular, the cost of fluoridating water supplies to populations of 20,000 or more people works out at less than 1 US dollar per person.

Cost savings: The Task Force review then compared the costs of establishing and running fluoridation schemes with the healthcare costs averted, including those which would otherwise have been incurred in examining, filling and extracting decayed teeth. Based on presumed average caries reduction figures of between 15% and 33%, per capita annual cost benefits were calculated to range from 5.49 US dollars to 93.19 US dollars.

Cost benefits: From these figures it was possible to calculate cost-benefit ratios for different sizes of population served by fluoridation schemes.  A New Zealand study showed a cost-benefit ratio of nearly 50 to 1 for water fluoridation schemes serving populations of more than 300,000, and 1.2 to 1 for populations of 1,000 people.

Two US studies found cost-benefits ratios of 38 to 1 and 135 to 1 for populations of 20,000 and above.  An Australian study revealed a ratio of around 38 to 1 for populations of 1,000 and above.

The authors of the Task Force review conclude that community water fluoridation delivers a positive rate of return for investment.  In other words, it saves money as well as reducing dental caries

Reference

  1. Tao Ran, PhD, Sajal K. Chattopadhyay, PhD, and the Community Preventive Services Task Force (2016).  Economic Evaluation of Community Water Fluoridation:   A Community Guide Systematic Review.  American Journal of Preventive Medicine; 50 (6): 790-796.

    Available at: https://www.thecommunityguide.org/sites/default/files/publications/oral-ajpm-econ-fluoridation_0.pdf

QUOTE FROM US COMMUNITY PREVENTIVE SERVICES TASK FORCE REVIEW, 2015

“Recent evidence continues to indicate that the economic benefit of community water fluoridation exceeds the intervention costs.  Further, the benefit-cost ration increases with the population of the community.”

KEY FIGURES FROM US REVIEW

Based on presumed average caries reduction figures from water fluoridation of between 15% and 33%, per capita annual cost benefits were calculated to range from 5.49 US dollars to 93.19 US dollars.