Globalization and Health

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Global affordability of fluoride toothpaste

Ann S Goldman1*, Robert Yee2, Christopher J Holmgren2 and Habib Benzian3

Author Affiliations

1 School of Public Health and Health Services, The George Washington University, Washington, DC, USA

2 WHO Collaborating Centre, Radboud University Medical Centre, Nijmegen, The Netherlands

3 FDI World Dental Federation, Ferney-Voltaire, France

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Globalization and Health 2008, 4:7 doi:10.1186/1744-8603-4-7

Published: 13 June 2008

Abstract

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.