Fluoridation could save NHS £millions
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- Published: Friday, 07 March 2014 00:09
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The NHS in England could save at least £4 million annually on hospital admissions for the removal of rotten teeth if water fluoridation were extended to areas with high levels of tooth decay, research published in the latest British Dental Journal (BDJ) suggests. The BDA’s Scientific Adviser, Damien Walmsley, said: “This study is a powerful reminder of how water fluoridation saves the NHS money, and how whole populations can benefit from a huge improvement in their dental health.”
Analysis by the researchers of hospital statistics over a three-year period suggests that on average 6,900 young people (aged up to 19 years) were admitted annually for dental extractions in the largely non-fluoridated North West. In the same period (the financial years 2006–7, 2007–8, 2008–9), the largely-fluoridated West Midlands saw on average just 1,100 admissions of young people per year for the same procedure.
Although the North West has a larger population it is only one-third greater than the West Midlands, which cannot account for such a large and unexpected difference seen for the each of the three years analysed, the research points out. When the two regions were broken down into 41 areas, the researchers suggest that the difference in hospital admissions rates between the North West and the West Midlands could not be accounted for by deprivation either. Using the old primary care trust (PCT) boundaries, 19 out of the 20 areas with the highest rates of hospital admissions were found in the North West. Compared to the Heart of Birmingham, the most deprived PCT area in England, Liverpool PCT, the second most deprived area, had 27 times more hospital admissions. Liverpool was closely followed by Blackpool, which witnessed 25 times more operations, and Manchester 22 times more.
Using data from 2008–9, the cost of carrying out a dental extraction under general anaesthetic £558 or £789 (depending on the complexity of the procedure), bringing the total cost of the operations to around £4 million in the North West. As well as the cost to the NHS, the operations would have meant personal cost to the patient and their family, in terms of the pain and sleepless nights associated with severe tooth decay, time lost from work or school, and the distress of having the extraction.
The authors of An alternative marker for the effectiveness of water fluoridation: hospital extraction rates for dental decay, a two-region study, observed that the striking difference in hospital admission rates for the two regions was not a one-off, but a clear, consistent and enduring pattern for each of the three financial years they studied. They conclude that extending water fluoridation would not only save the NHS money, it would also free up time, dental surgical expertise and prevent many young people from having to undergo traumatic dental extractions.
The British Dental Association’s Scientific Adviser, Professor Damien Walmsley, said: “This study is a powerful reminder of how water fluoridation saves the NHS money, and how whole populations can benefit from a huge improvement in their dental health. It’s a shocking fact that over 25,000 young people in England last year suffered such poor dental health that they had to have teeth removed under general anaesthetic in hospital. Undergoing such an operation at a tender age also increases the likelihood of patient anxiety about visiting the dentist and may discourage them from seeking further care until their condition reaches another state of emergency. Fluoridation not only reduces the need for this painful and distressing procedure, it can also reduce the dental health gap between children from socially disadvantaged and affluent backgrounds. Overwhelmingly, studies have shown this to be a safe and effective measure for reducing high rates of tooth decay. Living and working in Birmingham as I do, means that I see the benefits of fluoridation daily in a city where the water has been fluoridated for 50 years.”
The report is published in March 8, 2014 edition of the British Dental Journal. Research was carried out by specialists in dental public health: Timothy Elmer; John Langford, and Alexander J Morris.
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