RESUMEN
BACKGROUND: Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs. OBJECTIVE: To examine the reported cost-effectiveness of CWF. METHODS: Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined. RESULTS: Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected. CONCLUSIONS: Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.
Asunto(s)
Análisis Costo-Beneficio , Atención Odontológica/economía , Caries Dental/economía , Caries Dental/prevención & control , Fluoruración/economía , Fluorosis Dental/economía , Humanos , Estados UnidosRESUMEN
OBJECTIVE: To discuss the relations of dental fluorosis and the social economic status in fluorosis-stricken villages where drying the corn by burning coal was prevail. METHODS: A total of 6 fluorosis-endemic villages and one non-endemic village were involved in the study. The general fluorine intake and the concentrations of fluorine in corn, in the pupils' were tested. Dental fluorosis among the pupils was also examen. A individual interview or household questionnaire survey was conducted to probe the economic condition and staple food structure in 600 adults. RESULTS: The fluorosis prevalence was lower in the villages of transportation convenience, higher income, less coal-dried corn intake. There was a declining trend of dental fluorosis in the corresponding age groups (r: 0.912, 0.916; P < 0.05); There was no significant changes in age-specified dental fluorosis in the low income villages. The correlation (r) of corn fluorine concentration and student's age-specified dental fluorosis prevalence and disparity was 0.755 - 0.980 (P < 0.05) and 0.302 - 0.811; The urine fluorine concentrations were 0.811 and 0.915 (P < 0.05). It was assumed that there was a negative correlation between family cash income and the dental fluorosis. CONCLUSIONS: The corn fluorine concentration is closely related to age-specified dental fluorosis. With the economic improvement, taking less coal-burned corn is the one of major factors in reducing the of dental fluorosis in these areas.
Asunto(s)
Conducta Alimentaria , Flúor/análisis , Fluorosis Dental/economía , Fluorosis Dental/epidemiología , China , Carbón Mineral , Análisis Factorial , Flúor/orina , Humanos , Población Rural , Zea maysRESUMEN
In order to find out the situation of management and application of water defluoridation measures, as well as the effects on the prevention of endemic fluorosis in 10 provinces and cities with heavy endemic fluorosis from the drinking water sources, 1960 water engineering projects accounting for about 10% of all projects were investigated. The authors applied uniform method, criteria and forms to carry out the retrospective investigation. The data were entered into the computer database and analyzed statistically. The results demonstrate that all the defluoridation projects have significant effectiveness on the prevention of endemic fluorosis. The concentrations of water fluoride were below 1 mg/L. The prevalences of dental fluorosis were 30%-40% and the main type was light dental fluorosis. But with the time prolonging, less attention has been paid in man.