By Ken Perrott 07/12/2017


The ordinary person – not the taxation-financed health system – is the main financial beneficiary of community water fluoridation, according to a new study from New Zealand researchers.

Their research confirmed that community water fluoridation in New Zealand is highly cost-effective for all but the smallest communities. This study updates previous evaluations by including data for adults – previous studies were limited to children. It also corrected for under-estimation of averted dental restoration costs in a previous study.

The authors also make the point that an update is necessary because:

“Sound public health practice requires periodic re-evaluation of interventions’ benefits and costs.”

The results are reported in the paper:

Moore, D., Poynton, M., Broadbent, J. M., & Thomson, W. M. (2017). The costs and benefits of water fluoridation in NZ. BMC Oral Health, 17(1), 134.

Community size

As with previous studies, the results confirmed that fluoridation is not cost effective for very small communities because of the capital cost of fluoridation plants and the use of sodium fluoride instead of fluorosilicic acid as the fluoridating chemical in small plants. However:

“For ‘minor’ through to ‘large’ plants, there is a net cost saving. For a ‘large’ plant supplying 50,000 people, the cost offsets are over 20 times the cost of fluoridation. The break-even point appears to be reached by ‘minor’ plants supplying a population over 500.”

National net savings from universal fluoridation

The authours estimated the national costs and saving from averted ental costs over a 20 year period. If all New Zealand reticulated water supplies serving populations greater than 500 were fluoridated costs over 20 years would amount to$177 million while the cost offset due to averted dental treatment costs would be $1578 million.

The national 20-year net saving due to such universal community water fluoridation in NZ would amount to $1401 million.

That is a nine times pay-off!

Individuals save more than the state

I hadn’t thought of this before but the data enables separate estimates of savings to the state from universal CWF through reduced costs to the health budget, and to the individual citizen through their reduced costs for private dental treatment.

In fact, the major benefit is to the individual rather than the health budget.  National savings over 20 years for reduction of private dental care expenditure would be $1428 million – 10 times the savings to the national health budget.

Perhaps this helps people understand that they, personally, have something to gain financially from community water fluoridation.