Key points
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Introduction
Community-level interventions for the prevention of dental caries in children include fluoride varnish in schools, supervised tooth brushing in schools, provision of toothbrushes and toothpaste, and water fluoridation. The environmental impact of these interventions is an important factor to take into account when contracting these services.
Materials and methods
A life cycle comparative assessment (LCA) was conducted to quantify the environmental impact of fluoridation of the public water supply for a five-year-old child over a one-year period. These results were compared with LCA data for fluoride varnish in schools, supervised toothbrushing, and provision of toothbrushes and toothpaste.
Results
When comparing community-level caries prevention programs, water fluoridation had the lowest environmental impact across all 16 categories and had the lowest impact on disability-adjusted life years.
Discussion
All caries prevention programs at the community level have an associated environmental cost. Water fluoridation performed well in this LCA study across all measures of environmental sustainability. The results of this study could be used, along with cost and clinical effectiveness data, to inform public health policy.
Comments
Researchers have demonstrated the low environmental footprint of water fluoridation compared to other preventative measures for tooth decay. The research findings also strengthen the international case for water fluoridation programs to reduce tooth decay, particularly in the most vulnerable populations.
Researchers from Trinity College Dublin collaborating with University College London have demonstrated for the first time the low environmental footprint of water fluoridation compared to other dental caries preventive measures. The study is published in the British Dental Journal .
Water fluoridation is considered one of the most important public health interventions of the 20th century. But as the climate crisis worsens, the contribution of healthcare and disease prevention to the crisis must be considered. The action is urgent.
Influenced by this urgency, researchers quantified the environmental impact of water fluoridation for a five-year-old child over a one-year period and compared it to traditional fluoride varnish use and toothbrushing programs, which take place in Selected schools from across the UK. and internationally.
Today, more than 35% of the world’s population has access to water fluoridation, with studies showing significant reductions in tooth decay. While data are available on the clinical effectiveness and cost analysis of water fluoridation, until now there has been no data on its environmental impact.
To quantify this impact, the research team conducted a life cycle assessment (LCA) by carefully measuring the combined travel, weight and quantities of all products and processes involved in the three preventive programs (tooth brushing, fluorine varnish and water fluoridation). The data was entered into a specific environmental program (OpenLCA) and the team used the Ecoinvent database, allowing them to calculate the environmental results, including the carbon footprint, the amount of water used for each product and the amount of use from the earth.
Results from the study, led by Brett Duane, associate professor of dental public health at Trinity College, concluded that water fluoridation had the lowest environmental impact across all categories studied and had the lowest impact on life-adjusted life years. disability compared to all other community-level caries prevention programs. The study also found that water fluoridation provides the greatest return on investment.
Considering the balance between clinical effectiveness, cost-effectiveness and environmental sustainability, researchers believe that water fluoridation should be the preventive intervention of choice.
This research strengthens the case internationally for water fluoridation programs to reduce dental cavities, especially in the most vulnerable populations.
Associate Professor Duane said: "As the climate crisis begins to worsen, we need to find ways to prevent disease to reduce the environmental impact of our health systems. This research clearly demonstrates the low carbon impact of water fluoridation as an effective prevention tool.
Professor Paul Ashley, Senior Clinical Professor (Honorary NHS Consultant), UCL Eastman Dental Institute added: “Renewed efforts must be made to increase access to this intervention.”
