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Investigating the effectiveness of water fluoridation
Darshini Ramasubbu1, Jonathan Lewney2, Brett Duane3
1Dublin Dental University Hospital, Trinity College Dublin, Dublin, Republic of Ireland. ramasubd@tcd.ie.
Evidence-Based Dentistry
|July 3, 2024
Summary
Water fluoridation shows minimal oral health benefits, with small reductions in dental treatments and Decayed Missing and Filled Teeth (DMFT). However, it offers a positive return on investment for the public sector due to low program costs.
Area of Science:
- Public Health
- Dental Research
- Health Economics
Background:
- Water fluoridation is a public health measure to prevent tooth decay.
- Its effectiveness and cost-effectiveness in the UK's National Health Service (NHS) require ongoing evaluation.
Purpose of the Study:
- To assess the impact of water fluoridation on NHS dental treatments and Decayed Missing and Filled Teeth (DMFT).
- To evaluate the cost-effectiveness of water fluoridation for the public sector.
Main Methods:
- Retrospective cohort study using 10-year NHS treatment claims data.
- Individualized fluoride exposure assigned; participants matched using propensity scores.
- Analysis included regression models and Incremental Cost-Effectiveness Ratio (ICER) calculation.
Main Results:
- Optimally fluoridated group showed 3% fewer invasive treatments and 2% lower mean DMFT.
- No significant difference in missing teeth; greatest reduction in invasive treatments seen in most deprived deciles.
- Water fluoridation yielded savings of £22.26 per person, a 5.5% cost reduction for the NHS.
Conclusions:
- Water fluoridation demonstrates minimal oral health benefits and small reductions in NHS dental service utilization.
- The intervention shows a positive return on investment for the public sector due to low program costs versus high dental treatment expenses.
- Study did not account for initial fluoridation program setup costs.
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