Context
A recently updated Community Guide systematic review of the effectiveness of community
water fluoridation once again found evidence that it reduces dental caries. Although
community water fluoridation was found to save money in a 2002 Community Guide systematic
review, the conclusion was based on studies conducted before 1995. Given the update
to the effectiveness review, re-examination of the benefit and cost of community water
fluoridation is necessary.
Evidence acquisition
Using methods developed for Community Guide economic reviews, 564 studies were identified
within a search period from January 1995 to November 2013. Ten studies were included
in the current review, with four covering community fluoridation benefits only and
another six providing both cost and benefit information. Additionally, two of the
six studies analyzed the cost effectiveness of community water fluoridation. All currencies
were converted to 2013 dollars.
Evidence synthesis
The analysis was conducted in 2014. The benefit-only studies used regression analysis,
showing that different measures of dental costs were always lower in communities with
water fluoridation. For the six cost-benefit studies, per capita annual intervention
cost ranged from $0.11 to $4.92 for communities with at least 1,000 population, and
per capita annual benefit ranged from $5.49 to $93.19. Benefit–cost ratios ranged
from 1.12:1 to 135:1, and these ratios were positively associated with community population
size.
Conclusions
Recent evidence continues to indicate that the economic benefit of community water
fluoridation exceeds the intervention cost. Further, the benefit–cost ratio increases
with the community population size.
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Article info
Publication history
Published online: January 06, 2016
Footnotes
☆The names and affiliations of Task Force members are at www.thecommunityguide.org/about/task-force-members.html
Identification
Copyright
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
