A cost effectiveness analysis of community water fluoridation in New Zealand

AIM: The aim of the study was to use recent data to determine whether Community Water Fluoridation (CWF) remains a cost effective public health intervention in New Zealand, given a reduction in dental caries in all communities over time. METHOD: Local authorities that fluoridated their water supplies were asked to complete a questionnaire regarding fixed and variable costs incurred from CWF. Cost savings were calculated using data from the 2009 New Zealand Oral Health Survey. The cost effectiveness of CWF in conjunction with treatment per dmft/DMFT averted was compared to an alternative of treatment alone. Calculations were made for communities with populations of less than 5,000, 5,000 to 10,000, 10,001 to 50,000 and greater than 50,000. RESULTS: CWF was cost effective in all communities at base case. CWF remained cost effective for communities over 5,000 under all scenarios when sensitivity analysis was conducted. For communities under 5,000 the there was a positive net cost for CWF under certain scenarios. CONCLUSION: In this study, CWF was a cost effective public health intervention in New Zealand. For smaller communities cost effectiveness would be more dependent upon the population risk profile of the community.