Title:  The effectiveness and cost of two fluoride program for children

Abstract:  Due to high fixed costs, low variable costs and a longer period of delivery, water fluoridation is more expensive for small population sizes and less expensive for larger ones. aim The aim of this study was to establish the population size where the cost-effectiveness of a community water fluoridation and a school-based mouthrinse programme coincide. Methods Effectiveness was determined by examining three groups of children for caries at age 12; children who had been on mouthrinse since age 6 (mouthrinse group n = 136), children who attended non-fluoridated schools (no fluoride group n = 100) and children who had been lifetime residents of a fluoridated community (fluoridated group n = 144). Fixed and variable costs of water fluoridation and the mouthrinse were calculated based on information provided by the local health authority and the firms supplying the fluoride plant. Results The mean DMFT for the fluoridated group was 1.25 (± 1.62), the mouthrinse group 1.32 (± 1.53) and the no fluoride group 1.82 (± 1.96). The results confirm previous reports [Holland et al., 1995] demonstrating almost equal effectiveness for water fluoridation and mouthrinse in caries reduction for this community at age 12. Conclusion In this case study, the cost of securing similar caries reductions at age 12 are lower for the mouthrinse program if the population of 12 year old children size is below 3,168 and lower for water fluoridation if the population size goes above this figure.