Bardsley P F, Taylor S, Milosevic A
Dept. of Restorative Dentistry, Birmingham Dental Hospital, University of Liverpool, Pembroke Place, Liverpool L3 5PS, UK.
Br Dent J. 2004 Oct 9;197(7):413-6; discussion 399. doi: 10.1038/sj.bdj.4811722.
The effect of water fluoridation upon dental erosion/tooth wear in the UK has not been investigated. This study aimed to compare the prevalence of tooth wear in 14-year-old schoolchildren in non-fluoridated and fluoridated districts of North West (NW) England. The influence of deprivation and tooth brushing was also investigated.
A random sample of 10% of the 14-year-old population in NW England was selected and stratified according to fluoridation status as determined from water authority postcode listings.
Tooth wear was scored on the labial, incisal and palatal/lingual surfaces of the 12 anterior teeth and the occlusal surfaces of the first molars. Enamel wear was scored 0, dentine was scored 1 or 2, dependent on whether less than or more than a third of the surface had exposed dentine. Secondary dentine or pulpal exposure scored 3. Townsend deprivation scores were gained from residential post codes.
A total of 2,351 children were examined, of which 637 (27%) lived in the one fluoridated district of South Cheshire and 1,714 (73%) lived in 11 non-fluoridated districts. Fifty-three per cent of the children had exposed dentine with significantly more males affected than females (p<0.001). In the fluoridated district, significantly fewer children had exposed dentine on labial and palatal smooth surfaces (p<0.001) but no differences were found for incisal and occlusal surfaces. The interaction of fluoridation and tooth brushing twice per day resulted in a significant (30%) reduction in erosion. Smooth surface wear was more prevalent in children resident in affluent areas.
Children in non-fluoridated districts are 1.5 times more likely to have smooth surface wear compared with children in fluoridated districts. Fluoridation and use of fluoridated toothpaste twice a day provide added protection from dental erosion. The risk of tooth wear is greater with increasing affluence.
在英国，尚未对水氟化作用于牙齿侵蚀/牙齿磨损的影响进行研究。本研究旨在比较英格兰西北部未进行水氟化地区和已进行水氟化地区14岁学童的牙齿磨损患病率。同时还调查了贫困状况和刷牙情况的影响。
从英格兰西北部14岁人群中随机抽取10%的样本，并根据自来水管理部门邮编列表确定的水氟化状况进行分层。
对12颗前牙的唇面、切缘和腭/舌面以及第一磨牙的咬合面的牙齿磨损情况进行评分。牙釉质磨损评分为0，牙本质磨损根据表面暴露牙本质是否少于或多于三分之一分别评分为1或2。继发性牙本质或牙髓暴露评分为3。从居住邮编获取汤森贫困评分。
共检查了2351名儿童，其中637名（27%）生活在南柴郡的一个已进行水氟化的地区，1714名（73%）生活在11个未进行水氟化的地区。53%的儿童有暴露的牙本质，男性受影响的比例显著高于女性（p<0.001）。在已进行水氟化的地区，唇面和腭面光滑表面有暴露牙本质的儿童明显较少（p<0.001），但切缘和咬合面未发现差异。水氟化与每天刷牙两次的相互作用导致侵蚀显著减少（30%）。光滑表面磨损在富裕地区的儿童中更为普遍。
与已进行水氟化地区的儿童相比，未进行水氟化地区的儿童出现光滑表面磨损的可能性高1.5倍。水氟化和每天使用两次含氟牙膏可提供额外的防牙齿侵蚀保护。随着富裕程度的增加，牙齿磨损的风险更大。
