Schweinsberg F, Netuschil L, Hahn T
Abteilung Allgemeine Hygiene und Umwelthygiene, University of Tübingen.
Zentralbl Hyg Umweltmed. 1992 Dec;193(4):295-317.
Drinking water fluoridation for caries prophylaxis is not a means of primary prevention: i.e., avoidance of sugar and microorganisms in the oral cavity; but rather a means of secondary prevention: e.g., prevention of bacterial production of carboxylic acid from sugar, and therapy: e.g., enhancement of enamel resistance to demineralization by incorporation of fluoride in remineralization of the enamel surface. Currently available epidemiologic studies on the effects of drinking water fluoridation reveal: reduction of the incidence of caries, particularly in children no detrimental health effects; cosmetically undesirable dental fluorosis may occur, however. Nevertheless, introduction of drinking water fluoridation in Germany is not recommendable because of: the greater effectiveness of primary caries prevention, the acceptance of which is reduced, however, by drinking water fluoridation the at least equal prophylactic effect of fluoride via other routes, e.g. via toothpaste the narrow range between beneficial and detrimental dosage the avoidance of fluoride-enriched waste water the prerogative of minimal manipulation of drinking water content.
饮用水加氟预防龋齿并非一级预防手段，即并非避免口腔中的糖分和微生物；而是二级预防手段，例如预防细菌利用糖分产生羧酸，以及治疗手段，例如通过在牙釉质表面再矿化过程中加入氟化物来增强牙釉质抗脱矿能力。目前关于饮用水加氟效果的流行病学研究表明：龋齿发病率降低，尤其是在儿童中；对健康无不良影响；然而，可能会出现外观上不理想的氟斑牙。尽管如此，在德国不建议引入饮用水加氟，原因如下：一级龋齿预防效果更佳，但其接受度因饮用水加氟而降低；通过其他途径（例如通过牙膏）摄入氟化物至少具有同等的预防效果；有益剂量和有害剂量之间的范围很窄；避免产生富含氟化物的废水；尽量减少对饮用水成分进行处理的特权。
