Drinking water fluoridation in South East Queensland: a cost-effectiveness evaluation

Abstract

Objective: The aim of this study is to examine cost-effectiveness of fluoridation of drinking water supplies for Brisbane and South East Queensland. The benefits conveyed are expressed in reduced costs of dental treatment and years of life with dental caries as a disability. Methods: The analysis utilises a developed life table modelling initial cohort of 36,322 newborns, which when applied to the target population equals to 181,925 persons in the age group 2-100 years, 338,617 persons in the age group 7-100 years and 390,524 persons in the age group 12-100 years respectively. The analysis was conducted using a real discount rate of 3%. Sensitivity analyses investigated the effects of varying the parameters such as: discount rate, costs of dental treatment and costs of fluoridation plant. Uncertainty analysis was also conducted on costs and the measure of ratio of decayed, missing, filled teeth surfaces in deciduous dentition between the cities of Brisbane (non-fluoridated) and Townsville (fluoridated). Results: If fluoridation was implemented there would be a total saving of $10,437.43 (95% CI 6,406.50-14,035.35) disability-adjusted life years (DALYs) and AU$ 665,686,529 (95% CI -$973,573,625- -$381,322,176). This result is both desirable and dominant as more DALYs are saved along with significant cost savings. Conclusion: Fluoridation remains still a very cost-effective measure for reducing dental decay. Key words: Cost-effectiveness, dental caries, fluoridation, South East Queensland, DMFS, DMFT, dmfs, dmft, DALY.