Modelling lifelong costs of caries with and without fluoride use

Cost-benefit or cost-cost analyses are becoming increasingly important in dentistry. Therefore, the aim of the present study was to evaluate the economic consequences of caries prevention with fluorides. German epidemiological data were used in a system dynamics model to assess the lifelong costs of caries in a population. Without fluoride prevention, lifelong treatment for caries resulted in mean costs of 6,976 euro and a present value of 932 euro per person (5% discounting). In different scenarios of constant, increasing, or decreasing caries-controlling effects, and of limited (age 6-18 yr) or lifelong application, the combination of fluoride salt, fluoride toothpaste, and fluoride gel were most cost-effective. They reduced the costs for caries treatment and prophylaxis to 482, euro or to a present value of 148 euro (5% discounting), when applied from age 6-18 yr, and to 211-213 euro for lifelong use (present value, 5% discounting). In conclusion, a lifelong model of costs of caries demonstrates that the use of fluorides in caries prevention is highly cost-effective.