The impact of changing dental needs on cost savings from fluoridation.
BACKGROUND
Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia.


METHODS
Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized.


RESULTS
With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal.


CONCLUSIONS
Community water fluoridation remains a cost-effective preventive measure in Australia.
Campain
A C
AC
Melbourne Dental School, The University of Melbourne, Victoria, Australia.
Mariño
R J
RJ
Wright
F A C
FA
Harrison
D
D
Bailey
D L
DL
Morgan
M V
MV
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003442:Crowns / Q000191:economics; D004245:DMF Index; D003729:Dental Care / Q000191:economics*; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control; D003793:Dental Restoration, Permanent / Q000191:economics; D005457:Fluoridation / Q000191:economics*; D017048:Health Care Costs; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D018803:Models, Economic; D009909:Oral Health; D013997:Time Factors; D014739:Victoria; D055815:Young Adult