Twetman S
Dept. Cariology and Endodontics, Faculty of Health Sciences, University of Copenhagen, Denmark.
Eur Arch Paediatr Dent. 2008 Mar;9(1):12-8. doi: 10.1007/BF03321590.
This was to examine the literature published during the last decade and review the effectiveness of methods used for the prevention of early childhood caries (ECC).
A critical review of papers.
A broad search of the PubMed database was conducted from 1998 through September 2007, using "early childhood caries", "baby bottle tooth decay", "nursing caries", "infant caries", "caries prevention" and "oral health education" as index terms. Relevant papers published in English between 1998 and 2007 were identified after a review of their abstracts. Papers were selected if they reported a prospective controlled design with preventive or non-invasive intervention directed to children under the age of 3 years. A defined endpoint measure of cavitated or non-cavitated clinical caries, expressed as incidence or prevalence, was required. The targeted publications were critically assessed by the author concerning design, methodology and performance.
The initial search revealed 66 papers of which 22 met the inclusion criteria. The results reinforced the role of fluoride toothpaste as the most cost-effective home-care measure and semi-annual fluoride varnish applications as the best professional method for infants at risk. The evidence concerning the preventive effect of antibacterial agents, primary-primary prevention and dental health education were inconclusive but the included studies supported the importance of early start, outreach activities and motivational interviewing as key factors to overcome cultural and socioeconomic barriers.
Although there is a body of evidence for the use of fluoride in preventing ECC, further high-quality studies are needed to further establish the best way to maintain oral health in infants.
本研究旨在回顾过去十年发表的文献，并评估用于预防幼儿龋齿（ECC）的方法的有效性。
对论文进行批判性综述。
使用“幼儿龋齿”“奶瓶龋”“喂养龋”“婴儿龋”“龋病预防”和“口腔健康教育”等索引词，对1998年至2007年9月期间的PubMed数据库进行广泛检索。在对摘要进行审查后，确定了1998年至2007年期间以英文发表的相关论文。如果论文报告了针对3岁以下儿童的前瞻性对照设计以及预防性或非侵入性干预措施，则将其纳入。需要有明确的终点测量指标，即空洞型或非空洞型临床龋齿的发病率或患病率。作者对选定的出版物在设计、方法和性能方面进行了严格评估。
初步检索发现66篇论文，其中22篇符合纳入标准。结果进一步证实了含氟牙膏作为最具成本效益的家庭护理措施的作用，以及每半年应用一次氟保护漆作为高危婴儿最佳专业方法的作用。关于抗菌剂的预防效果、一级预防和口腔健康教育的证据尚无定论，但纳入的研究支持早期开始、外展活动和动机访谈作为克服文化和社会经济障碍的关键因素的重要性。
尽管有大量证据表明使用氟化物可预防幼儿龋齿，但仍需要进一步开展高质量研究，以进一步确定维持婴儿口腔健康的最佳方法。
