Return on Investment

In addition to being interventions effective in promoting oral health, community water fluoridation and dental sealant programs also provide a positive return on investment.


Community Water Fluoridation

  • One year of providing fluoridated water in the United States is estimated to save $6.5 billion in averted direct and indirect dental treatment costs.1
  • Communities served by fluoridated water save an average of $32 per person a year by avoiding treatment for cavities.1
  • The return on investment for community water fluoridation varies with size of the community, increasing as the community size increases, and is cost-saving even for small communities. Communities of 1,000 or more people see an average estimated return on investment of $20 for every $1 spent on water fluoridation.1

School Sealant Programs

  • Delivering dental sealants to children at high risk for cavities can be cost-saving to Medicaid by averting more expensive treatment costs.2
  • School sealant programs that serve students at high risk for cavities can become cost-saving in 2 years and save $11.70 per sealed tooth over 4 years.3
  • School sealant programs could save up to $300 million in averted costs by providing sealants to the 6.5 million children from low-income families who need them.3

Medical-Dental Integration

  • The health care system could save up to $100 million each year if dental offices performed screenings for diabetes, high blood pressure, and high cholesterol. Medical-dental integration between oral health and chronic disease prevention programs benefits patients and saves money.4

Featured Return on Investment Infographics


  1. O’Connell JM, Rockwell J, Ouellet J, Tomar SL, Maas W. Costs and Savings Associated with Community Water Fluoridation in the United States. Health Affairs. 2016. 1;35(12):2224-2232.
  2. Griffin SO, Naavaal S, Scherrer CR, Patel M, & Chattopadhay S. Evaluation of school-based dental sealant programs: A Community Guide systematic economic review. Am J of Prev Med. 2017;52(3):407-415.
  3. Centers for Disease Prevention and Control. Vital signs: dental sealant use and untreated tooth decay among U.S. school-aged children. MMWR. 2016;65(41):1141–1145.
  4. Nasseh K, Greenberg B, Vujicic M, Glick M. The effect of chairside chronic disease screenings by oral health professionals on health care dollars. Am J Public Health. 2014;104(4):744–750.