Stephen K W, Macpherson L M, Gorzo I, Gilmour W H
Dental Public Health Unit, University of Glasgow Dental School, Scotland, UK.
Community Dent Oral Epidemiol. 1999 Jun;27(3):210-5. doi: 10.1111/j.1600-0528.1999.tb02012.x.
Salt fluoridation is effective at inhibiting caries, but fluorosis prevalence data are deficient.
The purpose was to undertake a blind study of caries and tooth mottling in 8th grade school pupils from south-east Hungary who had resided (test) or not resided (control), until November 1985, in a 350 ppm F-/kg domestic salt-fluoridated area during their early years of life.
In Szeged, blind clinical caries and anterior tooth mottling scoring (+10% repeats) of 49 previously salt-fluoridated (mean age 14.14 years) and 59 non-salt-fluoridated subjects (mean age 14.08 years) were undertaken by one examiner, in June 1997. In addition, radiographic and photographic recordings were taken. In Glasgow, four dental and two lay staff scored the projected 35 mm colour transparencies (+10% repeats) of each pupil's six upper anterior teeth, for tooth mottling. All clinical, radiographic and photographic data were then analysed.
Mean DMFS scores were 9.18 (SD=10.72) for test users and 4.51 (SD=6.24) for control users (P<0.01) and, based on repeat observations, clinical reliability=0.99; X-ray reliability=0.95. Clinically, three test children had fluorosis of 10 teeth, with eight teeth in two controls. Photographic scoring by the clinical examiner gave a 97.2% clinical match, while photographic agreements for all four dentist pairs were 92.5%-97.2%, with lay observers' agreements at 89.8%. For both groups, 10% repeats produced 98.5% agreements. In a sole test case "fluorosis" photographic unanimity was obtained, and non-unanimous "possible fluorosis" was recorded by two to four panel members for only three other test and two control subjects.
No evidence was found that significant anterior tooth fluorosis resulted in subjects exposed previously to 350 ppm F-/kg domestic salt from birth to 2.3-4.8 years of age. However, no caries benefit was demonstrated after the 11.5-year salt fluoridation gap. Caries differences seemed social class-related, city-based controls having less disease than rural test subjects, in spite of an identical F- tablet regimen in all schools from 1987, until subjects were 10 years old. These data emphasise (a) the superiority of sustained community-delivered fluoridation and (b) the need to maintain constant fluoride delivery to tooth surfaces, certainly well beyond 10 years of age.
食盐氟化对于抑制龋齿有效，但氟斑牙患病率数据不足。
旨在对匈牙利东南部八年级学生的龋齿和牙齿斑纹情况进行一项盲法研究，这些学生在其幼年时期（直至1985年11月）曾居住在（试验组）或未居住在（对照组）一个氟含量为350 ppm F⁻/kg的家庭食盐氟化地区。
1997年6月，在塞格德，由一名检查者对49名先前接受过食盐氟化的受试者（平均年龄14.14岁）和59名未接受食盐氟化的受试者（平均年龄14.08岁）进行盲法临床龋齿和上前牙斑纹评分（10%重复）。此外，还进行了影像学和摄影记录。在格拉斯哥，四名牙科工作人员和两名外行人对每个学生的六颗上前牙的35毫米彩色投影幻灯片进行斑纹评分（10%重复）。然后对所有临床、影像学和摄影数据进行分析。
试验组使用者的平均DMFS评分为9.18（标准差=10.72），对照组使用者为4.51（标准差=6.24）（P<0.01），基于重复观察，临床可靠性=0.99；X线可靠性=0.95。临床上，三名试验组儿童有10颗牙齿出现氟斑牙，两名对照组儿童有8颗牙齿出现氟斑牙。临床检查者的摄影评分临床匹配率为97.2%，而四对牙医的摄影一致性为92.5%-97.2%，外行人观察者的一致性为89.8%。两组的10%重复检查一致性为98.5%。在一个单独的试验病例中获得了“氟斑牙”摄影一致性，只有另外三名试验组和两名对照组受试者有两至四名小组成员记录为非一致的“可能氟斑牙”。
未发现有证据表明，从出生到2.3 - 4.8岁期间曾接触过350 ppm F⁻/kg家庭食盐的受试者出现明显的上前牙氟斑牙。然而，在食盐氟化中断11.5年后未显示出龋齿预防益处。龋齿差异似乎与社会阶层有关，尽管从1987年到受试者10岁时所有学校的氟片服用方案相同，但以城市为基础的对照组龋齿比农村试验组少。这些数据强调了（a）持续社区提供氟化的优越性，以及（b）需要持续向牙齿表面提供氟化物，肯定要超过10岁。
