Macpherson Lorna M D, Conway David I, Gilmour W Harper, Petersson Lars G, Stephen Kenneth W
Dental Public Health Unit, University of Glasgow Dental School, Glasgow, UK.
Acta Odontol Scand. 2007 Jun;65(3):149-55. doi: 10.1080/00016350601137244.
To assess levels of fluorosis and fluorosis of esthetic concern in children from a naturally fluoridated and a non-fluoridated area of Sweden, and to determine the relative contributions of fluoridated water, parental educational level, and infant oral health-related behaviors.
A parental questionnaire collected information concerning child F-supplement and F-dentifrice usage histories, and socio-economic status. Photographic examination of 1336 subjects (F=791; N-F=545) was undertaken. Fluorosis was assessed (blind to F-exposure) in a random sample (n=250) of 35 mm slides by four dental and two lay "jurors" (with 10% random repeat-viewing for inter-observer and intra-observer agreement). Four outcomes were assessed on each slide: fluorosis at any level, fluorosis of esthetic concern, acceptability of appearance, and treatment needs. Ordinal logistic regression models were used to determine significant determinants.
For presence of fluorosis of esthetic concern, majority jury agreements (>3 of 6) were seen in only 2.3% (N-F) and 13.4% (F) pupils (p<0.001), albeit jurors unanimously scored only 13 F and 2 N-F exposed children as having esthetically unacceptable fluorosed teeth (p<0.001). The over-riding significant factor in terms of fluorosis of esthetic concern was exposure to water fluoridation in infancy in both unadjusted and adjusted models.
The important factor in relation to fluorosis of esthetic concern was explained by exposure to fluoridated water in infancy, and was not explained by age, sex, level of parental education or early childhood oral health behaviors. However, prevalence of this condition was relatively low. These findings should inform policies on appropriate total fluoride exposure levels during infancy.
评估瑞典自然高氟地区和非高氟地区儿童的氟中毒水平及美观性氟中毒情况，并确定饮用水加氟、父母教育水平和婴儿口腔健康相关行为的相对影响。
通过家长问卷收集有关儿童氟补充剂和含氟牙膏使用史以及社会经济状况的信息。对1336名受试者（F组 = 791名；非F组 = 545名）进行了摄影检查。由四名牙科专业人员和两名外行人组成的“评审员”（随机重复观察10%以评估观察者间和观察者内的一致性）对35毫米幻灯片的随机样本（n = 250）进行氟中毒评估（对氟暴露情况不知情）。在每张幻灯片上评估四个结果：任何程度的氟中毒、美观性氟中毒、外观可接受性和治疗需求。使用有序逻辑回归模型确定显著的决定因素。
对于美观性氟中毒的存在，只有2.3%（非F组）和13.4%（F组）的学生获得了多数评审员的认可（6人中有超过3人认可）（p < 0.001），尽管评审员一致认为只有13名F组暴露儿童和2名非F组暴露儿童的氟斑牙在美观上不可接受（p < 0.001）。在未调整和调整模型中，与美观性氟中毒相关的首要显著因素是婴儿期接触加氟水。
与美观性氟中毒相关的重要因素是婴儿期接触加氟水，而不是年龄、性别、父母教育水平或幼儿口腔健康行为。然而，这种情况的患病率相对较低。这些发现应为婴儿期适当的总氟暴露水平政策提供参考。
