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Global Affordability of Fluoride Toothpaste


Global Affordability of Fluoride Toothpaste

Ann S Goldman et al. Global Health.


Objective: Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries.

Methods: Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head.

Results: The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g) of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head.

Conclusion: Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed.


Figure 1
Figure 1
Toothpaste (annual dosage) at lowest price as a proportion of annual household expenditures per capita. Cost of one annual dosage of toothpaste at the lowest price as a proportion of annual household expenditures per capita by population group for selected countries.
Figure 2
Figure 2
Days of household expenditures to pay for toothpaste (one person, one year) at the lowest price. Number of days of household expenditures required to pay for one annual dosage of toothpaste at the lowest price by country and population group. This figure includes countries for which the proportion was greater than 10% of a day of household expenditures.

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