title: A critique of recent economic evaluations of community water fluoridation.
abstract: 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.
authors.forename: Lee
authors.initials: L
authors.lastname: Ko
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Thiessen
mesh_terms: D003362:Cost-Benefit Analysis; D003729:Dental Care / Q000191:economics*; D003731:Dental Caries / Q000191:economics* / Q000517:prevention & control*; D005457:Fluoridation / Q000191:economics*; D009050:Fluorosis, Dental / Q000191:economics; D006801:Humans; D014481:United States
keywords: Caries prevention,; Cost benefit,; Cost effectiveness,; Cost of water fluoridation,; Dental fluorosis; Economic evaluation,; Effectiveness in adults,; Water fluoridation,