Using Updated Economic Analysis to Promote Community Water Fluoridation

Since 2001 policymakers have relied on an economic evaluation, calculated in 1995 US dollars, that demonstrated community water fluoridation (CWF) continued to be cost-saving, even after the decline in dental caries prevalence since introduction of several fluoride modalities. Some have questioned whether this is still true 20 years later.  The Pew Charitable Trusts recently contracted with researchers to update inputs for economic analysis. The cost of fluoridating communities of various sizes in several states was determined using industry-standard formulas and recent contracts. The increment of decay in non-fluoridated areas was estimated by comparing differences over two decades of cross-sectional national survey data. The cost of restoring decayed teeth and maintaining restorations was estimated using claims data from three commercial dental plans. The new data enable CWF advocates to make credible estimates of cost implications specific to each community and the policy choice it faces-- whether to start or discontinue CWF.