2014/12/03 by Kok‐Onn Lee, Kathleen M. Thiessen · 18 citations
Environmental Science · Dentistry · Medicine · Chemistry · #Fluoride Effects and Removal #Dental Health and Care Utilization #Chemical Analysis and Environmental Impact #Water fluoridation #Environmental health #Environmental science #Medicine #Chemistry
paper · pdf · doi:10.1179/2049396714y.0000000093
published in International Journal of Occupational and Environmental Health 21(2), 91-120 (Maney Publishing)
openalex publication_date 2014/12/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
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.