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Article looks at savings associated with community water fluoridation

March 21, 2017

By Michelle Manchir

Water fluoridation saves Americans billions of dollars in tooth decay prevention, according to an article published in Health Affairs.

The study, led by researchers from the Colorado School of Public Health, found that savings associated with patients avoiding dental caries in 2013 as a result of fluoridation were estimated to be about $6.8 billion, or $32.19 per person, for the more than 211 million people who had access to fluoridated water through community water systems serving more than 1,000 people that year. Based on estimated costs of the systems to fluoridate ($324 million), the authors, whose article was published online in December, estimate the net savings from fluoridation to be about $6.5 billion, and the estimated return on investment 20 to 1 across water systems of all sizes.

The researchers noted that the cost to fluoridate could vary greatly from community to community, especially when considering variables such as the size of the community served with larger systems benefitting from economies of scale and the number of locations where fluoride would need to be added to the system.

The authors recommend that rather than using this study’s estimated return on investment based on national data, communities might better inform their policy decisions by computing their specific annual costs to fluoridate and comparing those costs to the study’s annual savings per person ($32.19) in averted treatment costs.
“While communities should assess their specific costs for continuing or implementing (community water fluoridation), these updated findings indicate that program savings are likely to exceed costs,” the authors write in the article, “Costs And Savings Associated With Community Water Fluoridation In The United States.”
The authors point out a number of study limitations, including assumptions that were made in the analysis based on national data obtained in the 1980s and in 2004.

Noting that the U.S. has not yet met the Healthy People 2020 objective to have 79.6 percent of the population served by community water systems receiving optimally fluoridated water, the article concludes that  “public understanding of water fluoridation and its benefits merits further study.” The authors note that this study could help inform the public about costs and savings that could aid communities in understanding the value of fluoridation.  Community water fluoridation is effective in helping to prevent caries, saves money and its “implementation and continuation should be given high consideration when assessing options to improve health and reduce health disparities,” the authors write.

The Pew Charitable Trusts funded this study.