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Equilibrium effects of public goods: The impact of community water fluoridation on dentists

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  • Katherine Ho
  • Matthew Neidell

Abstract

In this paper we consider how the dental industry responded to the addition of fluoride to public drinking water. We take advantage of the staggered introduction of fluoridation throughout the country to analyze the changes in numbers of within-county dentists relative to physicians in the years surrounding the change in fluoridation status. We find a significant decrease in the number of dental establishments and an even larger reduction in the number of employees per firm following fluoridation. We also find that fluoridation in neighboring markets was associated with an increase in own-market dental supply, suggesting that dentists responded to the demand shock by moving from fluoridated areas to close-by markets. Further analysis suggests that some dentists may have retrained as specialists rather than moving geographically. Our estimates imply that the 8 percentage point change in exposure to water fluoridation from 1974 to 1992 may have led to the loss of as many as 0.6 percent of dental establishments and 2.1 percent of dental employees, suggesting a substantial net impact of this public good on the dental profession since its inception.

Suggested Citation

  • Katherine Ho & Matthew Neidell, 2009. "Equilibrium effects of public goods: The impact of community water fluoridation on dentists," NBER Working Papers 15056, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:15056
    Note: HC HE IO LS PE
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    References listed on IDEAS

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    Cited by:

    1. Timothy Dunne & Shawn D. Klimek & Mark J. Roberts & Daniel Yi Xu, 2013. "Entry, exit, and the determinants of market structure," RAND Journal of Economics, RAND Corporation, vol. 44(3), pages 462-487, September.
    2. Tanya Wanchek & Terance J. Rephann & William Shobe, 2011. "Oral Health and the Dental Care Workforce in Southwest Virginia," Reports 2011-03, Center for Economic and Policy Studies.

    More about this item

    JEL classification:

    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • L22 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Organization and Market Structure

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