Skip to main content
SpringerLink
Log in

Economic Evaluation of Dental Caries Prevention Programs Using Milk and its Products as the Vehicle for Fluorides: Cost Versus Benefits

  • Chapter
  • First Online:
Nutrients, Dietary Supplements, and Nutriceuticals

Part of the book series: Nutrition and Health ((NH))

Key Points

  • Milk fluoridation represents an example of the use of potential nondental resources in achieving oral health objectives.

  • For the situations equivalent to those prevailing in Chile, milk fluoridation would be successful within the setting of existing food programs, largely acceptable to the community, likely to be sustainable with minimal external input, and could be readily integrated into the food program activities.

  • From a societal perspectives, milk-fluoridation produce health improvements in a cost-effective way. From an economic perspective, it offers good value for money for public health programmes.

  • This study estimates that a milk-fluoridation programme targeting children living in nonfluoridated areas of rural Chile would have savings to the society, and that the concerned with dental caries averted would implied health gains to the community.

  • Public health policy and practice have the potential of bringing considerable monetary and human benefits. There is a lack of studies evaluating the economic as well as the health consequences of community-based dental caries prevention in developing countries.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Chile is divided administratively in 15 Regions

  2. 2.

    The dmft index is the sum of deciduous teeth (t) that are decayed (d), missing (m), or filled (f) due to dental caries. The dmfs index is the equivalent for tooth surface (s).

  3. 3.

    In Chile primary education is from Year 1 to Year 8.

  4. 4.

    The DMFT index is the sum of permanent teeth (T) that are decayed (D), missing (M), or filled (F) due to dental ­caries. The DMFS index is the equivalent for tooth surface (S).

References

  1. Department of Health (UK). An oral health strategy for England. London: Department of Health; 1994.

    Google Scholar 

  2. Australian Health Ministers’ Advisory Council. Healthy mouths healthy lives. Australia’s National Oral Health Plan 2004-2013. Adelaide: South Australian Department of Health; 2004.

    Google Scholar 

  3. Jones S, Burt B, Petersen PE, Lennon MA. The effective use of fluorides in public health. Bull World Health Org. 2005;83:670–6.

    PubMed  Google Scholar 

  4. World Health Organization. Fluorides and oral health. Report of a WHO expert committee on oral health status and fluoride use. WHO Technical Report Series 846. Geneva: World Health Organization; 1994.

    Google Scholar 

  5. Künzel W. Systemic use of fluoride - other methods: salt, sugar, milk, etc. Caries Res. 1993;27 Suppl 1:16–22.

    Article  PubMed  Google Scholar 

  6. O’Mullane D. Systemic fluorides. Adv Dent Res. 1994;8:181–4.

    PubMed  Google Scholar 

  7. Mariño R. ¿Se debe fluorurar la leche? Bol Oficina Sanit Panam. 1996;75:98–109.

    Google Scholar 

  8. National Health and Medical Research Council (Australia). Review of water fluoridation and fluoride intake from discretionary fluoride supplements. Canberra: NH&MRC; 1999.

    Google Scholar 

  9. Browne D, Whelton H, O’Mullane D. Fluoride metabolism and fluorosis. J Dent. 2005;33:177–86.

    Article  PubMed  CAS  Google Scholar 

  10. Horowitz HS. Decision-making for national programs of community fluoride use. Community Dent Oral Epidemiol. 2000;28:321–9.

    Article  PubMed  CAS  Google Scholar 

  11. Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the United States. Morb Mortal Wkly Rep. 2001;50 RR14:1–42.

    Google Scholar 

  12. US Department of Health and Human Services. Review on fluorides. Benefits and risks. Washington, DC: US Department of Health and Human Services; 1991.

    Google Scholar 

  13. Estupiñan S. Promoting oral health. The use of salt fluoridation to prevent dental caries. Washington, DC: Pan American Health Organization; 2005.

    Google Scholar 

  14. Pan American Health Organization. Informe final. 1ra. Reunión de expertos sobre fluoruración y yodación de la sal de consumo humano. Antigua, Guatemala. 1986. PAHO/WHO, Washington, DC; 1990.

    Google Scholar 

  15. Marthaler TM, Menghini G, Steiner M, Sener-Zanola de Crousaz P, Corti M, Eckardt A. Excreción urinaria de fluoruro en niños que consumen suplementos de fluoruro en la sal o el agua. Arch Odontoestomatol Prev Comunitaria. 1992;4:27–35.

    Google Scholar 

  16. World Health Organization. The world oral health report 2003. Geneva: World Health 47. Organization, http://www.who.int/oral_health (2003). Accessed 3 Jan 2006.

  17. Niessen LC, Douglass C. Theoretical considerations in applying benefit–cost and cost-effectiveness analyses to preventive dental programs. J Public Health Dent. 1984;44:156–68.

    Article  PubMed  CAS  Google Scholar 

  18. Crowley SJ, Morgan MV, Wright FAC. Economic evaluation of a dental sealant and fluoride mouthrinsing ­program in two non-fluoridated regions of Victoria. Centre for Health Program Evaluation, Working Paper 57. Melbourne: University of Melbourne; 1996.

    Google Scholar 

  19. Murray C, Evans DB, Acharya A, Baltussen R. Development of WHO guidelines on generalized cost-­effectiveness analysis. Health Econ. 2000;9:235–51.

    Article  PubMed  CAS  Google Scholar 

  20. Ericsson Y. The state of fluorine in milk and its absorption and retention when administered in milk. Investigation with radioactive fluorine. Acta Odontol Scand. 1958;16:51–77.

    Article  CAS  Google Scholar 

  21. Poulsen S, Larsen MJ, Larson RH. Effect of fluoridated milk and water on enamel fluoride content and dental ­caries in the rat. Caries Res. 1976;10:227–33.

    Article  PubMed  CAS  Google Scholar 

  22. Villa A, Torti H. Informe final: Desarrollo y elaboración de leche fluorurada. Santiago: Fondo de Desarrollo Inductivo, CORFO; 1988.

    Google Scholar 

  23. Jones S, Crawford AC, Jenner AM, Roberts JTP, Lennon MA. The possibility of school milk as a vehicle for ­fluoride: epidemiological, organisational and legal considerations. Community Dent Health. 1992;9:335–42.

    PubMed  CAS  Google Scholar 

  24. Villa A, Guerrero S, Cisternas P, Monckeberg F. La prevención de la caries a través de un vehículo nutricional. Arch Latinoam Nutr. 1990;40:197–209.

    PubMed  CAS  Google Scholar 

  25. Ophaug R, Singer. Fluoride intake of infants and young children and the effect of supplemental and non-dairy sources of fluoride. Compendium. 1988;9:68–75.

    PubMed  CAS  Google Scholar 

  26. Clovis J, Hargreaves J. Fluoride intake from beverage consumption. Community Dent Oral Epidemiol. 1988;16:11–5.

    Article  PubMed  CAS  Google Scholar 

  27. Rusoff LL, Konikoff BS, Fyre JB, Johnston JE, Fyre WW. Fluoride addition to milk and its effect on dental caries in school children. Am J Clin Nutr. 1962;11:94–101.

    PubMed  CAS  Google Scholar 

  28. Tala H. Practical considerations concerning alternatives uses of fluorides. En: Pan American Health Organization: Artículos enviados a la conferencia de flurouros. Vienna, Austria 3–5 October 1982. Washington, DC: PAHO/WHO; 1984.

    Google Scholar 

  29. Villa A, Guerrero S, Cisternas P, Monckeberg F. Fluoride bioavailability from disodium monofluorphosphate ­fluoridated milk in children and rats. Caries Res. 1989;23:179–83.

    Article  PubMed  CAS  Google Scholar 

  30. Muhler JC, Weddle DA. Utilizability of fluorine for storage in the rat when administered in milk. J Nutr. 1955;55:347–52.

    PubMed  CAS  Google Scholar 

  31. Ekstrand J, Ehrnebo M. Influence of milk products on fluoride availability in man. Eur J Clin Pharmacol. 1979;16:211–5.

    Article  PubMed  CAS  Google Scholar 

  32. Duff EJ. Total and ionic fluoride in milk. Caries Res. 1981;15:406–8.

    Article  PubMed  CAS  Google Scholar 

  33. Zahlaka M, Mitri O, Munder H, Mann J, Kaldavi A, Galon H, et al. The effect of fluoridated milk on caries in Arab children. Clin Prev Dent. 1987;9:23–5.

    PubMed  CAS  Google Scholar 

  34. Stephen KW, Boyle IT, Campbell D, McNee S, Fyffe JA, Jenkins AS, et al. A 4-year double-blind fluoridated milk study in a vitamin-D deficient area. Br Dent J. 1981;151:287–92.

    Article  PubMed  CAS  Google Scholar 

  35. Stephen KW, Boyle IT, Campbell D, McNee S, Boyle P. Five-year double-blind fluoridated milk study in Scotland. Community Dent Oral Epidemiol. 1984;12:223–9.

    Article  PubMed  CAS  Google Scholar 

  36. Wirz R. Ergebnisse des Grossversuches mit fluoridierter Milch in Winterhur von 1958 bis 1964. Schweiz Monatsschr Zahnheilkd. 1964;74:767–84.

    Google Scholar 

  37. Ziegler E. Bericht über den Winterhurer Grossversuch mit Fluorzugabe zur Haushaltsmilch. Helv Paediatr Acta. 1964;19:343–54.

    PubMed  CAS  Google Scholar 

  38. Sampaio Lopes E, de Magalhaes Bastos JR, Zaniratto JE. Prevencao da carie dentária através da fluoretacao do leite servido a escolares de Agudos-SP, durante 16 meses. Rev Assoc Paul Cir Dent. 1984;38:419–26.

    Google Scholar 

  39. Imamura Y. Treatment of school meals with sodium fluoride as means of preventing tooth decay. J Oral Dis Acad. 1959;26:180–99.

    Google Scholar 

  40. Bánóczy J, Zimmermann P, Hadas E, Pinter A, Bruszt V. Effect of fluoridated milk on caries: 5-year results. J R Soc Health. 1985;105:99–103.

    Article  PubMed  Google Scholar 

  41. Bánóczy J, Zimmermann P, Pinter A, Hadas E, Bruszt V. Effect of fluoridated milk on caries: 3-year results. Community Dent Oral Epidemiol. 1983;11:81–5.

    Article  PubMed  Google Scholar 

  42. Gyurkovics C, Zimmerman P, Hadas E, Bánóczy J. Effect of fluoridated milk on caries: 10 years results. J Clin Dent. 1992;3:121–4.

    PubMed  CAS  Google Scholar 

  43. Light AE, Bibby BG, Smith FA, Gardner DW, Hodge HC. Fluoride content of teeth from children who drank ­fluoridated milk. J Dent Res. 1968;17:668.

    Google Scholar 

  44. Legett B, Garbee W, Gardiner J, Lancaster DN. The effect of fluoridated chocolate flavored milk on caries ­incidence in elementary school children: two and three–year studies. J Dent Child. 1987;54:18–21.

    Google Scholar 

  45. Yeung CA, Hitchings JL, Macfarlane TV, Threlfall AG, Tickle M, Glenny AM. Fluoridated milk for preventing dental caries. Cochrane Database Syst Rev. 2005; Issue 3. Art. No.:CD003876.pub2. doi: 10.1002/14651858. CD003876.pub2.

    Google Scholar 

  46. Kolesnik A, Phillips P, Villa AE. Physico-chemical studies on milk fluoridation. In: Stephen KW, Bánóczy J, Pakhomov GN, editors. Milk fluoridation for the prevention of dental caries. (WHO/ORH/MF/DOC96.1). Geneve: WHO; 1996. p. 10–26.

    Google Scholar 

  47. World Health Organization Global health. Milk-fluoridation–background. http://www.whocollab.odont.lu.se/wpro. Accessed 15 July 2005.

  48. Mariño, Villa A, Weitz A. Dental caries prevention using milk as the vehicle for fluorides: the Chilean experiences. Melbourne: The School of Dental Science, University of Melbourne’s Community Dental Health Monograph Series. No. 12. ISBN 07340 2734 6; 2006.

    Google Scholar 

  49. Ministerio de Salud de Chile. Normas de uso de fluoruros en la prevención odontológica. Santiago: Departamento Odontológico, Ministerio de Salud de Chile; 1998.

    Google Scholar 

  50. Ministerio de Salud de Chile. Objetivos Sanitarios y Modelos de Salud para la Década 2000–2010. Santiago: Ministerio de Salud de Chile; 2002.

    Google Scholar 

  51. Ministerio de Salud Chile (2008) Norma de Uso de Fluoruros en la Prevención Odontológica. Norma General Técnica Nº 105. Ministerio de Salud de Chile, Santiago

    Google Scholar 

  52. Ministerio de Salud de Chile. Aprueba ampliación de convenio de colaboración Ministerio de Salud con Junta Nacional de Auxilio Escolar y. Becas Decreto exento No. 991, 30 de Diciembre del 2003. Santiago: Ministerio de Salud de Chile; 2003.

    Google Scholar 

  53. Instituto Nacional de Estadísticas, Mapa interactivo. www.ine.cl/index.php. Accessed 21 Apr 2003.

  54. Kain J, Uauy R. Targeting strategies used by the Chilean national supplementary feeding program. Nutr Res. 2001;21:677–88.

    Article  CAS  Google Scholar 

  55. Uauy R, Kain J. The epidemiological transition: need to incorporate obesity prevention into nutrition programmes. Public Health Nutr. 2002;5(1A):223–9.

    Article  PubMed  Google Scholar 

  56. Drummond MF, O’Brien B, Stoddart GL. Methods for the economic evaluation of health care programmes. New York: Oxford University Press; 1997.

    Google Scholar 

  57. Mariño R, Villa A, Guerrero S. A community trial for fluoridated powdered milk in Chile. Community Dent Oral Epidemiol. 2001;29:435–42.

    Article  PubMed  Google Scholar 

  58. Urbina T, Caro JC, Vincent M. Dental caries and enamel fluorosis in 6–8 and 12–year-old Chilean children [In Spanish]. Santiago: Departamento Odontológico, Ministerio de Salud de Chile; 1997.

    Google Scholar 

  59. Weitz A, Villa AE. Reduction of caries in rural school-children exposed to fluoride through a milk-fluoridation programme in Araucania, Chile. Community Dent Health. 2007;24:186–91.

    PubMed  CAS  Google Scholar 

  60. Drummond M, Sculpher M, Torrance G, O’Brien B, Stoddart G. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford University Press; 2005.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Melbourne Dental School, University of Melbourne, Parkville, Victoria, Australia

    Rodrigo Mariño

Authors
  1. Rodrigo Mariño
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Fajardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mike Morgan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rodrigo Mariño .

Editor information

Editors and Affiliations

  1. University of Arizona Mel and Enid Zucke, 1295 N. Martin, Tucson, 85724-5155, USA

    Joe K Gerald

  2. Arizona Health Science Center, Mel and Enid Zuckerman College of Public, University of Arizona, 1501 N. Campbell Ave. Room 4335, Tucson, 85724-5155, Arizona, USA

    Ronald Ross Watson

  3. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Mariño, R., Fajardo, J., Morgan, M. (2011). Economic Evaluation of Dental Caries Prevention Programs Using Milk and its Products as the Vehicle for Fluorides: Cost Versus Benefits. In: Gerald, J., Watson, R., Preedy, V. (eds) Nutrients, Dietary Supplements, and Nutriceuticals. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-60761-308-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-308-4_11

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-307-7

  • Online ISBN: 978-1-60761-308-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation