Thank you Marshall! Definitely agree with you about the limitations of DALYs—as useful as they can be in some contexts—and the point that sugar taxes likely have benefits beyond oral health. I think sugar taxes (and maybe other regulation, like trans fat regulation) are likely to be impactful in part from having pretty broad-reaching benefits that aren’t reflected in my CEA here (blood pressure/ cardiovascular health, obesity, oral health, etc etc).
Thanks also for the note about the cause exploration prizes! Unfortunately, I think this piece is too long (and now has already been published online)—so I don’t think it’s eligible (? not quite sure) but i’ll check it out!
Hm I don’t think that follows from the review- I would ideally like more studies looking at whether fluoride can affect IQ (esp at high concentrations), but I don’t think this should be the highest priority thing.
I want to highlight that the ‘low level evidence’ refers to fluoride at high concentrations. As I’ve outlined above, I think that fluoride interventions should only be used in areas with low fluoride levels. See the start of that review’s discussion, where it reads ‘This systematic review and meta-analysis gathered evidence showing that, following the WHO classification of low and high levels in the drinking water, exposure to low/adequate water F levels is not associated with any neurological damage, while exposure to high levels is. The level of evidence for this association, however, was considered very low.’
I could still see an argument to add in a risk factor to my CEA, but (bearing in mind that this is in a low fluoride area) I think this risk is sufficiently small that it is not worth including. For example, I haven’t included a factor for ‘not in pain = can go to school = higher IQ/ earnings’ which I’d argue has more support behind it. Nonetheless, I will keep an open mind and watch out for any new studies about this.