Effectiveness of water fluoridation in reducing tooth decay
The effectiveness of water fluoridation in reducing tooth decay has long been established from individual studies comparing dental health in fluoridated and non-fluoridated communities.
Systematic reviews of the worldwide evidence published between 2000 and 2015 have confirmed that fluoridation does, indeed, reduce both the severity and prevalence of tooth decay:
The York review (2000) found an average reduction of about 40% in the average number of decayed, missing and filled teeth per child in fluoridated areas compared with non-fluoridated areas, and an increase of around 15% in children with no experience of tooth decay.
US Task Force review
A US Task Force review (2002) estimated average reductions in tooth decay in children of between 30% and 50%.
Review of benefits for adults
A review of previous studies of adults (2007) by a group of US researchers (Griffin et al) found that, on average, those who had lived all their lives in fluoridated areas had between 27% and 35% fewer decayed, missing and filled teeth than those who had always lived in non-fluoridated areas.
Cochrane Oral Health Group review
In 2015 a Cochrane Oral Health Group review reported that children in fluoridated areas had 35% fewer decayed, missing and filled deciduous teeth and 26% fewer decayed, missing and filled permanent teeth than those in non-fluoridated areas.
One in a Million
Our One in a Million online database includes a comprehensive section on the cost-effectiveness of fluoridation.
Studies of the cost effectiveness of water fluoridation
There is evidence from a number of studies that water fluoridation is a cost-effective – possibly the most cost-effective – means of reducing tooth decay. They include a 1998 report by the York Economics Consortium Read more, a study by US researchers published in 2001 Read more, and an updated review by a US Community Preventive Services Task Force published in 2016. Read more
Comparing fluoridation costs with those of fillings and extractions
Figures from Public Health England show that the cost of fluoridating water supplied to around 6 million people across the country was just over £2 million in 2014/15.
This works out at about 35 pence per person per annum served by those fluoridation schemes and contrasts significantly with the £54 it costs on average to perform of a single filling of decayed tooth on the NHS or the £558 it costs on average to undertake tooth extractions under a general anaesthetic in hospital.
The least expensive way to deliver the benefits of fluoride to all residents of a community
The US Centers for Disease Control and Prevention says: “Community water fluoridation is not only safe and effective, but it is also cost-saving and the least expensive way to deliver the benefits of fluoride to all residents of a community.
“For larger communities of more than 20,000 people, it costs about 50 cents per person to fluoridate the water. It is also cost-effective because every $1 invested in this preventive measure yields approximately $38 savings in dental treatment costs.
“This method of fluoride delivery benefits all people regardless of age, income, education, or socioeconomic status. A person’s income and ability to get routine dental care are not barriers since all residents of a community can enjoy fluoride’s protective benefits just by drinking tap water and consuming foods and beverages prepared with it.
“Fluoride from other sources prevents tooth decay as well, whether from toothpaste, mouth rinses, professionally applied fluoride treatments, or prescription fluoride supplements. These methods of delivering fluoride, however, are more costly than water fluoridation and require a conscious decision to use them.”