Abstract
BackgroundThis study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years.MethodsAfter 6 years, children in the milk-fluoridation program had a significant (34%) reduction in dental caries experience compared to those in the comparison community (i.e., received school milk without added fluoride) (DMFS: 1.06 vs. 1.60).ResultsThis improvement was achieved with an investment of Thailand Baht (THB) 5,345,048 over 6 years (or THB 11.88 per child, per year) (1 US$ = THB(2011) 30.0). When comparing the costs of the operation of the program and dental treatment in the test community with those of the comparison community, the program resulted in a net societal savings of THB 8,177,179 (range 18,597,122 to THB 7,920,711) after 6 years. This investment would result in 40,500 DMFS avoided in a community with a childhood population of 75,000 [DMFS avoided: 75,000 x (− 0.54)].ConclusionsWhile the analysis has inherent limitations due to its dependence on a range of assumptions, the results suggest that, from a societal perspective, when compared with the non-intervention group, the Bangkok Metropolitan Administration intervention appeared to be a more cost-efficient option than current standard oral health care.
Highlights
This study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years
Calculations based on data provided from the Royal Chitralada Project indicate that the undiscounted investment necessary to produce both Pasteurized fluoridatedmilk and UHT fluoridated-milk is Thailand Baht (THB)(2011) 386,019.00 (See Table 1)
The total undiscounted annual cost to add fluoride to milk distributed by the Bangkok Metropolitan Administration (BMA) would be THB 113,892 per year
Summary
This study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years. The use of fluorides is recognized as one of the most successful measures for the prevention of disease in the history of public health [1]. Fluoride can be delivered to individuals as a dental preventive measure through a variety of mechanisms. Other mechanisms include school water fluoridation, fluoride mouthrinses, topical application of fluoride solution gels and milk fluoridation [2,3,4,5]. In Thailand, the oral health promoting school program is well established.
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