Global affordability of fluoride toothpaste

A team of researchers, which included Dr. Habib Benzian of FDI, Dr. Ann Goldman of the School of Public Health and Health Services at the George Washington University in Washington D.C., Dr. Robert Yee and Dr. Christopher Holmgren, experts to the FDI World Dental Development and Health Promotion Committee, compared the relative affordability of fluoride toothpaste in 48 countries. This study is the first to attempt to quantify the affordability of toothpaste across the globe.

According to the study, fluoride toothpaste is prohibitively expensive for the world's poorest people. Researchers revealed that the poorest populations of developing countries have the least access to affordable toothpaste.


Dental caries remain the most common disease worldwide where the use of fluoride toothpaste is the most effective preventive public health measure. 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.

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.

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 require 0.037 days of household expenditure to purchase the annual average dosage (182.5g) 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.

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.

Access to Article

> Global affordability of fluoride toothpaste, Ann S Goldman, Robert Yee, Christopher J Holmgren, Habib Benzian Globalization and Health 2008, 4:7 (13 June 2008)

FDI Press Release

> FDI supports efforts to promote fluoride for oral health
> La FDI soutient les efforts de promotion du fluor pour une santé bucco-dentaire
> FDI apoya los esfuerzos para promover el fluoruro en la salud bucodental
> FDI unterstützt Initiativen zur Förderung der Mundgesundheit durch Fluorid

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