{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T02:54:01Z","timestamp":1781924041049,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>For over 70 years, the addition of fluoride to public water as community water fluoridation (CWF or fluoridation) with intent to prevent dental caries continues to be controversial, and risks are seldom included in monetary evaluations. Published operational costs and benefits of fluoridation are used, whereas published and clinical experience treating dental fluorosis are utilized to estimate treatment costs of patient\u2010perceived dental fluorosis and lost wages from lower IQ (intelligence quotient). Published estimated caries averted, less operational costs at $8 PPPY (per person per year) were used, compensation for functional and cosmetic dental fluorosis $126 PPPY, and lower earnings from presumed harm of developmental neurotoxicity estimated at $438 PPPY. Net loss from CWF is estimated at $556 PPPY, although some individuals will have significantly more or less loss. Previous economic evaluations of fluoridation have estimated caries averted and costs of operations; however, few evaluations include the costs of treating harm. Fluoridation is not cost\u2010effective if the cost of harm is included. Alternatives for the prevention of dental caries should be promoted, and the cessation of fluoridation is indicated.<\/jats:p>","DOI":"10.1002\/puh2.70009","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T11:41:28Z","timestamp":1732707688000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Community Water Fluoridation a Cost\u2013Benefit\u2013Risk Consideration"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-7105","authenticated-orcid":false,"given":"Bill","family":"Osmunson","sequence":"first","affiliation":[{"name":"Private Practice  Bellevue Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Griffin","family":"Cole","sequence":"additional","affiliation":[{"name":"Center for Advanced Dental Disciplines (CADD)  Fort Collins Colorado USA"},{"name":"American College of Integrative Biological Dental Medicine  Saddlebrook New Jersey USA"},{"name":"International Academy of Oral Medicine and Toxicology  Champions Gate Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39318.562951.BE"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1179\/2049396714Y.0000000093"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12800"},{"issue":"4","key":"e_1_2_11_5_1","first-page":"324","article-title":"Tooth Trends for 12 Year Olds in Nonfluoridated and Fluoridated Countries","volume":"38","author":"Neurath C.","year":"2005","journal-title":"Fluoride"},{"key":"e_1_2_11_6_1","volume-title":"Fluoride in Drinking Water A Scientific Review of EPA's Standards","author":"National Research Council of the National Academies","year":"2006"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12930"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0881"},{"issue":"6","key":"e_1_2_11_9_1","article-title":"Water Fluoridation for the Prevention of Dental Caries","volume":"2015","author":"Iheozor\u2010Ejiofor Z.","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2380084419830957"},{"key":"e_1_2_11_11_1","unstructured":"U.S. Environmental Protection Agency.Analysis of Costs for the Treatment of Dental Fluorosis EPA\/600\/5\u201087\/001 (NTIS PB87170817) (Washington D.C.:U.S. Environmental Protection Agency 1987)."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345930720090201"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/1807-3107BOR-2015.vol29.0014"},{"key":"e_1_2_11_14_1","unstructured":"Food & Water Watch Inc. v. United States Envtl. Prot. Agency EDWARD M. CHEN United States District Judge U.S. District Court Northern District of California. Case No. 17\u2010CV\u201002162\u2010EMC (KAW)."},{"key":"e_1_2_11_15_1","unstructured":"National Toxicology Program Public Health Service U.S. Department of Health and Human Services NTP Monograph on the State of the Science Concerning Fluoride Exposure and Neurodevelopment and Cognition: A Systematic Review (2024) https:\/\/ntp.niehs.nih.gov\/sites\/default\/files\/2024-08\/fluoride_final_508.pdf."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(23)00166-3"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2019.105315"},{"key":"e_1_2_11_18_1","unstructured":"E.Connett.American Environmental Health Studies Project. Unpublished accessed February 23 2024 https:\/\/fluoridealert.org\/researchers\/fluoride-iq-studies\/the-mother-offspring-fluoride-studies\/."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2021.112181"},{"key":"e_1_2_11_20_1","unstructured":"Neurath.Dose\u2010Response Assessment of Fluoride Neurotoxicity Studies. Submission to NAS and NTP. (2020) https:\/\/fluoridealert.org\/wp-content\/uploads\/neurath-2020.fan-dose-response-assessment-of-ntp-studies-with-corrections.pdf."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2023.03.011"},{"issue":"6","key":"e_1_2_11_22_1","first-page":"885","article-title":"Societal Costs of Exposure to Toxic Substances: Economic and Health Costs of Four Case Studies That Are Candidates for Environmental Causation","volume":"109","author":"Muir T.","year":"2001","journal-title":"Environmental Health Perspectives"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","unstructured":"P.Grandjean H.Hu C.Till et\u00a0al.A Benchmark Dose Analysis for Maternal Pregnancy Urine\u2010Fluoride and IQ in Children. medRxiv42 no.3(2020):439\u2013449 https:\/\/doi.org\/10.1111\/risa.13767.","DOI":"10.1111\/risa.13767"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCIDE.S444093"},{"issue":"3","key":"e_1_2_11_25_1","first-page":"148","article-title":"Biomimetic Hydroxyapatite and Caries Prevention: A Systematic Review and Meta\u2010Analysis","volume":"55","author":"Limeback H.","year":"2021","journal-title":"Canadian Journal of Dental Hygiene"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.11987"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T16:53:39Z","timestamp":1747673619000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/puh2.70009"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70009","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]},"assertion":[{"value":"2024-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70009"}}