Cavities and Fluoride in Children

Reviewed by The Clinical Committee

February 05, 2019

  • Over the last 20 years, improvements in dental health have been concentrated in wealthy families.

  • Research has shown that water fluoridation reduces much of this disparity.

  • In economic cost-benefit analysis, researchers estimate that water fluoridation provides $32 in benefits for every $1 in cost.

Statistics on Cavities in Kids

Statistics on cavities in kids

Over the past 20 years, we have seen enormous advances in healthcare. New medications have helped us nearly cure HIV, certain types of cancer, and many infectious diseases.

However, cavities remain a challenging issue. For many kids, their odds of getting cavities remain roughly the same today as they were 20 years ago.

According research in the Journal of Public Health Dentistry, poorer kids have approximately the same amount of cavities today than they did 20 years ago, while wealthy kids have 30-40% fewer cavities.

In the figure above, kids in four family income categories ranging from below poverty in the left-most column to wealthy kids in the right-most column were analyzed for average numbers of cavities in their adult teeth. For both age groups, we can see that the gap between rich and poor, when it comes to dental health, has grown over the past 20 years.

Effect of Water Fluoridation on Cavities

Effect of water fluoridation on cavitites

One factor that helps reduce some of this disparity is water fluoridation.

This remains a controversial topic because this treatment involves giving a medicine to an entire population in drinking water, sometimes without direct consent. Some individuals are understandably uncomfortable with this.

What we do know is that this improves dental health, particularly in poorer counties.

In order to estimate the effects of water fluoridation on cavities in the United States, researchers compared data on water fluoridation with data on kids' health.

In the chart above, the data shows that fluoridation has the greatest beneficial effect in poorer counties. Kids in poorer counties with fluoride in their water had 30% fewer cavities than kids in poorer counties without fluoride in their water.

Wealthier counties did not have as much benefit from water fluoridation. The number of cavities in fluoridated and un-fluoridated counties were nearly the same.

One reason may be that wealthy kids had better dental health to begin with, and may have gotten adequate fluoride from toothpaste, thus reducing the benefits of water fluoridation.

Cost-Benefit Analysis of Water Fluoridation on Cavities

Economic cost benefits of water fluoridation

Given the expense of dental work, it's no surprise that water fluoridation provides significant financial benefits, along with its health benefits.

While estimates may vary, many studies show that fluoridation costs around $1 per year per resident.

Source: Cost Savings of Community Water Fluoridation

This in turn provides around $32.00 per person per year in benefits. These include benefits from fewer cavities, fewer fillings, and fewer dental treatment costs.

Source: Costs And Savings Associated With Community Water Fluoridation In The United States.

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