Cost effectiveness

The cost of fluoridation is often understated and the savings drastically exaggerated
"We have shown that the promise of reduced dental costs was based on flawed analyses. In particular, the primary cost-benefit analysis used to support CWF in the U.S. assumes negligible adverse effects from CWF and omits the costs of treating dental fluorosis, of accidents and overfeeds, of occupational exposures to fluoride, of promoting CWF, and of avoiding fluoridated water."
Kathleen M. Thiessen
Ph.D.

Find out what fluoridation really costs us and the environment. Read our article:

"Water fluoridation is a wasteful failed medical experiment - an experiment on 6.5 million people in England who have never formally consented to being experimented on."
Joy Warren BSc. (Hons) Env Sc., co-authored with Geoff Pain PhD, BSc. (Hons)
A Complete Waste of Money!
Water Fluoridation Costs for England: 2013 – 2021

Joy Warren, BSc. (Hons) Env. Sc.
Geoff N Pain PhD, BSc. (Hons)
September 2017

“Not only is public finance being completely wasted, but the practice, which does not reduce dental health inequalities across social groups, pollutes our rivers, streams, lakes and soil and makes our bodies toxic.”

“Moreover, the medicine is ineffectual at preventing dental decay as demonstrated by Kakei et al in 2012. The 1987 NIDR study confirms that swallowed fluoride does not reduce dental decay and any difference between the DMFT and DMFS results for the study group and the control group were statistically insignificant. On the other hand, the medicine is highly efficient at causing dental fluorosis and a reduction in intelligence and this incurs hidden financial costs for affected individuals – costs which are not paid by the NHS. Other chronic illnesses are caused by bioaccumulated fluoride which is a systemic poison and which is multi-factorial. These illnesses are well documented in research literature. A vast library of research on adverse health effects of fluoride has been amassed under the umbrella group, the Fluoride Action Network.”

“Water fluoridation is a wasteful failed medical experiment – an experiment on 6.5 million people in England who have never formally consented to being experimented on.”

A critique of recent economic evaluations of community water fluoridation

Lee Ko and Kathleen M Thiessen

Int J Occup Environ Health. 2015 Mar; 21(2): 91–120.

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.

Abstract Conclusion: 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.

Full conclusion

For decades, the U.S. federal and state governments have promoted CWF to improve dental health of residents at low costs. Yet, in spite of the presumed savings in dental costs to Americans due to widespread use of CWF, employment of dentists is projected to grow by 16% between 2012 and 2022 (vs. 11% for all occupations), and cosmetic dentistry in the U.S. has grown to be a multi-billion dollar industry. We have shown that the promise of reduced dental costs was based on flawed analyses. In particular, the primary cost-benefit analysis used to support CWF in the U.S. assumes negligible adverse effects from CWF and omits the costs of treating dental fluorosis, of accidents and overfeeds, of occupational exposures to fluoride, of promoting CWF, and of avoiding fluoridated water. In assessing the benefits, it ignores important large data sets and assumes benefits to adults that are unsupported by data. Thus this analysis, as well as other economic analyses of CWF (Appendix 2), falls short of reasonable expectations for a cost-benefit analysis from a societal perspective. Minimal correction of methodological problems in this primary analysis of CWF gives results showing substantially lower benefits than typically claimed. Accounting for the expense of treating dental fluorosis eliminates any remaining benefit.