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BENEFITS ALTERNATIVES
OVERDOSE DISEASES PUBLIC COST |
COST EFFECTIVENESS Question
41. ADA's
Fluoridation Facts Short Answer ADA's
Fluoridation Facts Long Answer Historically, the cost to purchase fluoride compounds has remained fairly constant over the years in contrast to the continued rising cost of dental care.27 School-based dental disease prevention activities (such as fluoride mouthrinse or tablet programs), professionally applied topical fluorides and dental health education are beneficial but have not been found to be as cost-effective in preventing tooth decay as community water fluoridation.230 Fluoridation remains the most cost-effective and practical form of preventing decay in the United States and other countries with established municipal water systems.9, 58, 62, 230, 234 Due to the decay-reducing effects of fluoride, the need for restorative dental care is typically lower in fluoridated communities. Therefore, an individual residing in a fluoridated community will generally have fewer restorative dental expenditures during a lifetime. Health economists at a 1989 workshop concluded that fluoridation costs approximately $3.35 per tooth surface when decay is prevented, making fluoridation, "one of the very few public health procedures that actually saves more money than it costs."234 Considering the fact that the national average fee for a two surface amalgam (silver) restoration in a permanent tooth placed by a general dentist is $75.84*, fluoridation clearly demonstrates significant cost savings.235 The economic importance of fluoridation is underscored by the fact that frequently the cost of treating dental disease is paid not only by the affected individual, but also by the general public through services provided by health departments, welfare clinics, health insurance premiums, the military and other publicly supported medical programs.61 Indirect benefits from the prevention of dental decay may include:
These intangible benefits are difficult to measure economically, but are extremely important.58, 231 *The survey data should not be interpreted as constituting a fee schedule in any way, and should not be used for that purpose. Dentists must establish their own fees based on their individual practice and market considerations. Repeat
of Question 41. Opposition's Response Fluoridation cannot be cost-effective since it does not prevent tooth decay. (See Benefits section). " ... several recent studies, here and abroad, show that fluoridation is correlated with higher caries, rather than lower ones. ... There has been no study that shows any cost-saving by fluoridation. This claim has been researched by a Rand corporation study and found to be 'simply not warranted by available evidence'." (See 41-1: "The Truth About Mandatory Fluoridation" by John R. Lee, M.D. Apr. 15, 1995). A study was done to determine "The Amount of MediCal Money Spent in 1995 & 1994 for Dentistry in Relation to Fluoridation in the 15 largest Counties in California, which comprise 83% of the Eligible Recipients." (Tables are shown). "As is obvious from the above tables, fluoridation does not reduce MediCal dental treatment costs." The tables show that the cost is slightly higher in the fluoridated areas. "The statement made by Elizabeth G. Hill and Craig L. Brown, that fluoridated water systems ... reduce costs associated with dental treatment (including) ' ... higher Media-Cal dental costs' is so obviously false that the question of how such a statement could be made is worth examining." (See 41-2: Superior Court of the State of California statement, p.5, by Dr. John Yiamouyiannis, 1997). Dentists make 17% more profit in fluoridated areas as opposed to non-fluoridated areas. There are no savings. (See 41-3: "Impact of Water Fluoridation on Dental Practice and Dental Manpower" from The Journal of the American Dental Association, Vol. 84, Feb. 1972, pp. 355-367). The Natick Fluoridation Committee Report, dated September 27, 1999, included this statement on the cost-effectiveness of fluoridation:
"When a claimed 20% decrease in tooth decay is compared to a 600% increase in bone cancer or a 41% increase in hip fractures, when the cost of a tooth filling is compared to the cost of a hip fracture or cancer treatment, it is obvious that the human and economic costs of fluoridation are staggering." (Fluoridation-Why the Controversy?, by Janet Nagel, Ed.D., from National Health Federation.) Fluoridation is also a financial hazard to the electronics industry who rely on pure water. Lucent Microelectronics states it will probably cost them $5,000,000 to remove fluoride from the water they buy from the city. |
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