MEDIA9: Promoting brushing teeth with fluoride toothpaste
resolved Jul 10

As part of Charity Entrepreneurship's 2023 Top Ideas contest, will we select "Promoting brushing teeth with fluoride toothpaste" as a top Mass Media intervention?

Idea overview

Oral health has been largely neglected by global health interventions in recent decades, yet there is growing evidence linking poor oral health with high levels of pain and suffering, as well as poor health outcomes such as cardiovascular diseases and diabetes. Yet there is a simple and highly effective way of preventing oral diseases: daily tooth brushing with fluoride toothpaste. This organization would use mass-media communications to encourage the audience to consistently adopt behaviors that promote oral health, including more frequent tooth brushing, and using toothpaste with sufficient fluoride content.

Mass media interventions

By ‘mass media’ intervention we refer to social and behavior change communication campaigns delivered through mass media, aiming to improve human well-being. We intend to select 2-4 ideas out of the 10 presented to recommend to entrepreneurs who enter our incubation program. This market resolves YES if this idea is chosen; NO otherwise.

About the contest

In partnership with Charity Entrepreneurship, Manifold is sponsoring a $2000 forecasting tournament to inform which ideas end up selected

  • You can win part of a $1000 prize pool as a forecaster, for best predicting which interventions we choose.

  • You can win one of ten $100 prizes for posting an informative comment on Manifold that most influences our decision.

For contest details and all markets, see the group CE 2023 Top Ideas.

Get Ṁ600 play money

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I think this intervention is not as good as many of the others, but slightly undervalued. The neglectedness of dental care is a strong point here, and it seems likely that this intervention could have some solid impact. However, it is unclear to me whether this intervention would have an actual impact on people and whether or not they would be likely to put priority on dental care, which likely appears less important than it is. There is also a slight concern with whether it would be overprioritized relative to issues that are actually more important, though that seems somewhat unlikely.

I did some digging here and came away with mixed thoughts.

That being said, I came away less impressed by the scope and tractability of the issue. An estimated 43.7% of people in African regions have some "oral disease", but

  • It seems like this is defined broadly enough that mild tooth decay would qualify. The impact on standard of living seems like it would vary a lot but likely be much lower than the impact of FGM, vaccinations, or others.

  • A lot of the more severe oral health issues are unimpacted by brushing, such as cleft palate.

  • It's not clear how long-term the impact of these campaigns are. Presumably the highest value would be in producing long-term behavioral changes across people and generations, but I can find no evidence of this being caused by mass media.

I do disagree with @PatMyron on the policy v. mass media here though. If both flouridated and non-flouridated toothpaste are available inexpensively, it seems like mass media could change behaviors. I looked around and couldn't find any country deciding to ban or put a warning label on unflouridated toothpastes. Seems at least possible but would be new ground.

Based on some brief research, it seems that some parts of the developing world actually have too much fluoride based on naturally occurring stuff. I think this also discounts usage of chewing sticks/miswak, which apparently do pretty decently in terms of dental care.

Sufficient fluoride seems more suitable as a policy position than a mass media PSA. Fluoride toothpaste is available for a couple dollars/year even in rich countries, so there shouldn't be too many economic policy concerns, and consumers shouldn't have to know that much to buy suitable toothpaste

GPT-4 ranked this #9 of the 10

"Oral health is important, but compared to other issues like vaccination, maternal health, and welfare programs, it might be considered less urgent or impactful."