Seppä L
Department of Preventive Dentistry and Cariology, Faculty of Dentistry, University of Kuopio, Finland.
Proc Finn Dent Soc. 1991;87(4):541-7.
Despite the artificial fluoridation of drinking water in Kuopio, part of the children have high caries incidence. We therefore started our studies on fluoride varnishes in 1977 in an attempt to find a feasible means of applying fluoride topically in children at high risk of caries. In our first trial, the sodium fluoride varnish Duraphat was found to be effective in preventing caries, but the effectiveness of the silane fluoride varnish Fluor Protector could not be unequivocally established, despite the fact that Fluor Protector deposited markedly more fluoride in enamel than Duraphat. In a second study in children in a low-fluoride area, use of Duraphat was found to be more effective than fortnightly fluoride rinses or Fluor Protector. Increasing the frequency of application from two to four times a year did not increase the effectiveness of Duraphat even in highly caries-prone children in a 2-year trial. On the basis of peak values of fluoride in parotid saliva after application, use of either fluoride varnishes was considered safe. Although the fluoride content of the enamel remained elevated for at least two years after discontinuation of treatment with both varnishes, the caries preventive effect did not continue after the applications were stopped. This shows that increasing the fluoride content of enamel is not the main mechanism by which fluoride varnishes prevent caries, and that the applications need to be continued as long as caries is a problem.
尽管库奥皮奥的饮用水进行了人工氟化处理，但部分儿童的龋齿发病率仍然很高。因此，我们于1977年开始对含氟涂料展开研究，试图找到一种可行的方法，对龋齿高危儿童进行局部用氟。在我们的首次试验中，发现氟化钠含氟涂料Duraphat对预防龋齿有效，但尽管Fluor Protector在牙釉质中沉积的氟明显多于Duraphat，却无法明确证实硅烷氟化物含氟涂料Fluor Protector的有效性。在对低氟地区儿童进行的第二项研究中，发现使用Duraphat比每两周进行一次氟化物漱口或使用Fluor Protector更有效。在一项为期两年的试验中，即使是在龋齿高发儿童中，将Duraphat的使用频率从一年两次增加到四次，也并未提高其有效性。根据使用后腮腺唾液中氟的峰值，认为使用这两种含氟涂料都是安全的。尽管在用这两种含氟涂料治疗停止后，牙釉质中的氟含量至少在两年内仍保持升高，但停止使用后龋齿预防效果并未持续。这表明，提高牙釉质中的氟含量并非含氟涂料预防龋齿的主要机制，并且只要存在龋齿问题，就需要持续进行涂覆。
