Limeback H
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Community Dent Oral Epidemiol. 1999 Feb;27(1):62-71. doi: 10.1111/j.1600-0528.1999.tb01993.x.
The belief that fluoridated water reduces caries incidence by half stems from years of fluoridation studies where the caries rates of people in various fluoridated and non-fluoridated communities were compared. By their nature, the water fluoridation trials were not able to distinguish between the topical effects of the fluoride in the water and the systemic effects of the fluoride that is inevitably swallowed and incorporated into developing teeth. Some attempts have been made to estimate the contribution of systemic fluoride to the control of dental caries but researchers are discovering that the topical effects of fluoride are likely to mask any benefits that ingesting fluoride might have. In this updated review of the pre-eruptive vs. post-eruptive benefits of fluoride in the prevention of dental caries, a re-examination of the literature, which is often cited to support the notion that swallowing fluoride, either in water or in pill form, was done in recognition of the mounting evidence for the topical mechanism as being the primary mechanism for the prevention of dental caries. Maximum benefits from exposing newly erupted teeth to topical fluoride in the oral cavity may have been seriously under-estimated. This has obvious implications for the use of systemic fluorides to prevent dental caries and forces everyone working in the field to examine more closely the risks and benefits of fluoride in all its delivery forms.
认为氟化水能使龋齿发病率降低一半的观点源于多年的氟化研究，这些研究比较了不同氟化和非氟化社区人群的龋齿率。从本质上讲，水氟化试验无法区分水中氟化物的局部作用和不可避免地被吞咽并融入正在发育牙齿中的氟化物的全身作用。已经有人尝试估算全身氟化物对控制龋齿的贡献，但研究人员发现，氟化物的局部作用可能会掩盖摄入氟化物可能带来的任何益处。在这篇关于氟化物在预防龋齿中萌出前与萌出后益处的更新综述中，对文献进行了重新审视，这些文献常被引用来支持这样一种观点，即吞咽水中或药丸形式的氟化物，这是因为认识到越来越多的证据表明局部作用机制是预防龋齿的主要机制。新萌出牙齿暴露于口腔局部氟化物的最大益处可能被严重低估了。这对使用全身氟化物预防龋齿具有明显的影响，并迫使该领域的所有工作人员更仔细地审视各种氟化物输送形式的风险和益处。
