Cost-effectiveness is what’s key

By From page A10 | October 11, 2013

On Wednesday morning, I read with great amusement Bob Dunning’s column, which was mainly focused on the topic of fluoridation. This is not unusual, I often read Dunning’s column for amusement. And sometimes to pick up some homespun wisdom. But I do not read Dunning’s column for scientific advice.

There is a reason for that.

And it is demonstrated by Dunning’s strong support for Lucas Frerichs’¬†faulty thinking about the unit of analysis in this debate on community water fluoridation. Somehow Frerichs got confused about the unit of analysis in this debate when he focused heavily on the efficiency of the distribution of fluoride via the water system. This apparently was pivotal in his decision to not fluoridate.

Unfortunately, this point is almost entirely irrelevant because the unit of analysis is “the most effective way to secure significant improvement in oral health status of Davis residents” and not “how efficiently would fluoride be distributed in our water system.”

Introduction of the halogen fluoride (real close to that other halogen, chlorine, which we routinely put in our water) is very inexpensive (less than the cost of fluoridated toothpaste for a family of four for a year) and very effective in the reduction of caries in people of all ages.

In fact, the public health community has demonstrated over and over again, that community water fluoridation is the most effective method of improving oral health status … which is the goal of community water fluoridation.

This is called cost-effectiveness analysis, and we probably should learn to do this properly if we are to make intelligent decisions about fluoridation and other topics in the city of Davis.

John Troidl

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