Various cost data were obtained from routinely collected data as well as freedom of information requests. Where costs were not obtainable or unclear, expert opinion was sought.

Cost of treatment

Dental treatment is assumed to be provided by the NHS in England where available. Patients are charged according to how treatments map onto various bands, each of which is associated with a fixed fee to patients who are liable for NHS dental charges and, for the provider, a measure of delivered contracted activity.

To capture the societal costs, as well as to the National Health Service (NHS), the cost of treatment was taken by determining the average cost to the NHS of a Unit of Dental Activity (UDA) which better captures the average price dentists are remunerated by the NHS.

The cost of tooth extractions carried out in hospitals for children and adults was calculated independently. Price data was collected from NHS England’s National Cost Collection Data Publication (National Schedule of NHS Costs).

Capital and maintenance costs for CWF schemes  

Capital costs from new schemes were derived from the costs associated with the re-introduction of a scheme in Cumbria and estimated costs that had been determined for proposed new schemes in Southampton and Greater Manchester. Lifespan of equipment was assumed to be 50 years for ground preparation and buildings and 20 years for bulk and day tanks etc. 

Running and maintenance costs were determined from freedom of information costs about current schemes in England. 

Productivity loss costs

Costs associated with loss of productivity were determined per dental treatment episode by multiplying estimated length of time of treatment episode by the median gross wage for UK workers from the Office of National Statistics.