{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:34:18Z","timestamp":1773279258151,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The prevalence of dental caries is high in Japan, leading to a huge burden of overall expenditure on dental caries treatment for the population. School\u2010based fluoride mouth\u2010rinse (S\u2010FMR) has been implemented as a public health intervention. However, its cost\u2010effectiveness remains unclear, where universal health insurance covers a broad range of dental treatments at relatively low cost. The aim of the study was to determine whether S\u2010FMR is associated with lower dental caries treatment expenditure in Japan, where the universal health insurance system widely covers dental treatments. In addition, the cost\u2010benefit of S\u2010FMR was estimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This ecological study examined the association between S\u2010FMR coverage and dental caries treatment expenditure in all 47 prefectures of Japan. Data were obtained from the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data (NDB Open Data Japan), national survey data on the prevalence of S\u2010FMR, and other census data for each prefecture. The outcome variable was the average annual treatment expenditure of for children aged 5\u201314 per child. The explanatory variable was the S\u2010FMR coverage of children per prefecture, divided into quartiles: (Q1) 0.0%\u20130.48%, (Q2) 0.54%\u20136.9%, (Q3) 7.2%\u201325.0% and (Q4) 26.9%\u201380.4%. Linear regression analysis was performed with adjustment for the number of dental clinics per 100\u2009000 individuals, per capita prefectural income, and percentage of the population aged between 5 and 14\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The dental caries treatment expenditure was lower in prefectures with higher S\u2010FMR coverage: (Q1) 2378 JPY, (Q2) 2215 JPY, (Q3) 2217 JPY and (Q4) 2065 JPY. Linear regression analysis showed that, compared to the prefectures with the lowest S\u2010FMR coverage, the prefectures with the highest coverage exhibited significantly lower per person dental caries treatment expenditure by 186.0 (95% CI\u2009=\u200996.6, 275.4) JPY. When annual cost of S\u2010FMR per person was lower, 200 JPY, S\u2010FMR would save 0.9 billion JPY if all prefectures change from Q1 to Q4 (approximately 8.2 million USD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although public healthcare insurance in Japan covers most dental treatments at a relatively low cost, the current findings suggest that S\u2010FMR could still be a cost\u2010effective public health intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.13024","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T04:20:51Z","timestamp":1735186851000},"page":"216-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["School\u2010Based Fluoride Mouth\u2010Rinse Programs and Dental Caries Treatment Expenditure: An Ecological Study of the <scp>NDB<\/scp> Open Data Japan"],"prefix":"10.1111","volume":"53","author":[{"given":"Daisuke","family":"Tadokoro","sequence":"first","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazue","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taro","family":"Kusama","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-8955","authenticated-orcid":false,"given":"Kenji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Osaka","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Aida","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health Tohoku University Graduate School of Dentistry  Sendai Japan"},{"name":"Department of Dental Public Health, Graduate School of Medical and Dental Sciences Institute of Science Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,25]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO \u201cGlobal Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030 \u201d2022 https:\/\/www.who.int\/publications\u2010detail\u2010redirect\/9789240061484."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520908533"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517750572"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0528.2002.300108.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6831-13-17"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0528.2008.00457.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517693566"},{"issue":"12","key":"e_1_2_9_9_1","first-page":"241","article-title":"Ten Great Public Health Achievements\u2013United States, 1900\u20131999","volume":"48","author":"Centers for Disease Control and Prevention (CDC)","year":"1999","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01490-7"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12958"},{"key":"e_1_2_9_12_1","unstructured":"WHO \u201cF.5 Fluoride Formulations F.5b Fluoride Mouthrinse Application for New Medication: Fluoride Mouthrinse \u201dhttps:\/\/cdn.who.int\/media\/docs\/default\u2010source\/essential\u2010medicines\/2023\u2010eml\u2010expert\u2010committee\/applications\u2010for\u2010new\u2010formulations\u2010strengths\u2010of\u2010existing\u2010listed\u2010medicines\/f5b_fluoride\u2010mouthrinse.pdf?sfvrsn=87435c27_1."},{"key":"e_1_2_9_13_1","unstructured":"K.Takeuchi \u201cEvaluation of Fluoride Mouth\u2010Rinse Programs From a Health Economics Perspective (in Japanese) \u201d2022 https:\/\/mhlw\u2010grants.niph.go.jp\/system\/files\/report_pdf\/202122067A\u2010buntan4.pdf."},{"key":"e_1_2_9_14_1","unstructured":"Ministry of Health Labour and Welfare \u201cStatus of S\u2010FMR in Each Prefecture in 2018 \u201dhttps:\/\/www.mhlw.go.jp\/content\/000711481.pdf."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20150255"},{"issue":"7","key":"e_1_2_9_16_1","first-page":"439","article-title":"Dental Treatment and Expenditures Under General Anesthesia Among Medicaid\u2010Enrolled Children in North Carolina","volume":"39","author":"Meyer B. D.","year":"2017","journal-title":"Pediatric Dentistry"},{"key":"e_1_2_9_17_1","first-page":"k13","article-title":"Treating Early Childhood Caries Under General Anesthesia: A National Review of Canadian Data","volume":"86","author":"Schroth R. 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