A critique of recent economic evaluations of community water fluoridation

Lee, Kok-Onn; Thiessen, Kathleen M

doi:10.1179/2049396714y.0000000093

Cited by 16 publications

(14 citation statements)

References 72 publications

(238 reference statements)

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“…Thirty-four articles were selected for full text review. Of these, five were excluded due to being cost studies [18][19][20][21][22]; two due to being review articles [23,24]; two did not have comparators [25,26] and two articles were in French [27,28]. In addition, three articles were identified by hand search and other online sources.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluations in water-fluoridation: a scoping review

Mariño

Zaror

2020

BMC Oral Health

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Background: Community water fluoridation (CWF) is considered one of the 10 greatest public health achievements of the twentieth century and has been a cornerstone strategies for the prevention and control of dental caries in many countries. However, for decision-makers the effectiveness and safety of any given intervention is not always sufficient to decide on the best option. Economic evaluations (EE) provide key information that managers weigh, alongside other evidence. This study reviews the relevant literature on EE in CWF. Methods: A systematic database search up to August 2019 was carried out using MEDLINE, EMBASE, Cochrane Library, LILACS, Paediatric Economic Database Evaluation and National Health Service Economic Evaluation Database. The review included full economic evaluations on CWF programs, written in English, Spanish or Portuguese. The selection process and data extraction were carried out by two researchers independently. A qualitative synthesis of the results was performed. Results: Of 498 identified articles, 24 studies met the inclusion criteria; 11 corresponded to cost-benefit analysis; nine were cost-effectiveness analyses; and four cost-utility studies. Two cost-utility studies used Disability-Adjusted Life Years,, one used Quality-Adjusted Tooth Years, and another Quality-Adjusted Life Years. EEs were conducted in eight countries. All studies concluded that water fluoridation was a cost-effective strategy when it was compared with non-fluoridated communities, independently of the perspective, time horizon or discount rate applied. Four studies adopted a lifetime time horizon. The outcome measures included caries averted (n = 14) and savings cost of dental treatment (n = 4). Most of the studies reported a caries reduction effects between 25 and 40%. Conclusion: Findings indicated that CWF represents an appropriate use of communities' resources, using a range of economic evaluation methods and in different locations. These findings provide evidence to decision-makers which they could use as an aid to deciding on resource allocation.

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Section: Resultsmentioning

confidence: 99%

Economic evaluations in water-fluoridation: a scoping review

Mariño

Zaror

2020

BMC Oral Health

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“…To reduce the children’s oral health disparity, the effect of providing fluoridated water is significant for primary prevention. However, there are also disadvantages, such as cost and dental fluorosis ( 21 ). In the U.S., the dentists who accept government-assisted insurance is low ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of social geographic factors on the untreated tooth decay among head start children

Heima

Ferretti

Qureshi³

et al. 2017

J Clin Exp Dent

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BackgroundDisparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States.Material and MethodsThis was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children’s addresses were retrieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected.ResultsThe mean (standard deviation) of children’s age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children’s characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Population, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated ß-Coefficients (Standard Errors)=-0.003 (0.002), p=0.030).ConclusionsThis study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists may be a strategy to reduce the number of early childhood caries. Key words:Child, poverty, dental caries, Health Services Accessibility.

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“…According to the WHO standards, the recommended desirable fluoride limit in drinking water is 1.0 ppm and maximum permissible limit is 1.5 ppm, though this value may vary slightly depending upon temperature and climate [11]. Recently, the recommended level of fluoride present in drinking water has been brought down to 0.7 ppm [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Removal of fluoride from aqueous solution by porous Vaterite calcium carbonate nanoparticles

Abeykoon

Dunuweera

Liyanage

et al. 2020

Mater. Res. Express

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This study is based on a simple, low-cost and a novel approach towards the removal of excess fluoride ions from aqueous solution by absorbing fluoride on porous vaterite calcium carbonate nanoparticles (PVCCNPs) synthesised using ethylene glycol-water soft template method. SEM images clearly show the porous nature of aggregated nanoparticles present in the dry powder. Physicochemical properties of synthesised PVCCNP and fluoride on PVCCNP was characterised further by FTIR, XRD, XRF, EDX, and TGA-DTG. Fluoride removal by PVCCNPs from 100.00 ml of 10.0 mg l −1 NaF solution with 0.500 g of PVCCNPs, determined using a fluoride ion-selective electrode, indicates that around 90% removal is achieved within 1 h thus reducing the level to desired 1 ppm. The pseudo-second order kinetic model has a better fit to describe the adsorption of fluoride on PVCCNP than pseudofirst order model. The Langmuir isotherm model is more appropriate to describe the equilibrium behaviour of the adsorption process, than the Freundlich model. Given that the value of n (Freundlich constant) is greater than 1 (3.07) and R L value is in the range of 0<R L <1 (0.014-0.024) implies that the adsorption process is spontaneous and fluoride ions are favourably adsorbed on PVCCNPs. Langmuir model shows that the maximum adsorption capacity of fluoride is 1.956 mg g −1 . Excess fluoride in drinking waters causes several severe ill-health effects and filter media based on these nanoparticles can be used to remove fluoride down to safe and required levels to tackle these health problems. As such, PVCCNPs-based filter can be designed to remove fluoride in drinking waters. This may be a way for controlling fluorosis and many other diseases associated with excess fluoride present in drinking waters.

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A critique of recent economic evaluations of community water fluoridation

Cited by 16 publications

References 72 publications

Economic evaluations in water-fluoridation: a scoping review

Economic evaluations in water-fluoridation: a scoping review

The effect of social geographic factors on the untreated tooth decay among head start children

Removal of fluoride from aqueous solution by porous Vaterite calcium carbonate nanoparticles

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