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Oral health

Costs

Direct cost

The total spend on dental care in England in 2003/4 was approximately £3.8 billion including private dental treatment.

Indirect cost

Indirect costs, such as time off work to attend for dental treatment, are also a significant financial burden to society. Indeed, in one study, 148,000 hours of work were lost per 100,000 workers because of dental visits or problems over one year. 1

Dental caries are the second-most costly diet-related disease in Australia, with an economic impact comparable with that of heart disease and diabetes. 2 Approximately £1.52 billion was spent on dental services in 2001/02, representing 5.4% of total health expenditure.

Cost-effectiveness of preventing poor oral health

One area of cost-effectiveness studied is the application of fluoride: fluoride modalities are most cost-effective for people who are at high risk for dental caries. People who are at low risk of developing dental caries receive limited benefit from adding caries-preventive modalities to water fluoridation and fluoride toothpaste, even those demonstrated to be effective among populations at high risk.

Cost-effectiveness of caries prevention calculated that the average annual cost of water fluoridation in the United States was £0.21 per person (range: £0.06--£2.75). In 1999 dollars, this cost would be £0.36 per person (range: £0.08--£3.87).

A Scottish study, conducted in 1980, reported that community water fluoridation resulted in a 49% saving in dental treatment costs for children aged 4-5 years old and a 54% saving for children aged 11-12 years old. 3 These savings were maintained even after the long-term decline in the prevalence of dental caries was recognized. The effect of community water fluoridation on the costs of dental care for adults is less clear.

Using available evidence, the U.S. Surgeon General's report and the report of the Swedish Council on Technology Assessment in Health Care have attempted to determine the cost-effectiveness of oral health intervention programs from developed countries.

Among the findings were that water fluoridation costs about a dollar per person per year for water serving most individuals in the United States. Community water fluoridation is believed to be an effective and cost-effective caries preventive method.

Economic analyses of community dental sealant programs suggest that they are cost-effective and may even provide cost savings when used in high-risk populations. 4

References

  1. Gift HC, Resine ST, Larach DC. The social impact of dental problems and visits. Am J Public Health 1992;82:1663-1668. External Link External Link
  2. AHMAC Oral health of Australians. National planning for oral health improvement. Adelaide: South Australian Department of Human Services, 2001. External Link
  3. Downer MC, Blinkhorn AS, Attwood D. Effect of fluoridation on the cost of dental treatment among urban Scottish school children. Community Dent Oral Epidemiol 1981;9:112-116. External Link
  4. Bratthall D, Petersen PE, Ramanathan Stjernswärd J, Brown LJ. Oral and craniofacial diseases and disorders. In: Disease control priorities in developing countries (2nd edn), New York: Oxford University Press, 2006; p723-736.