Rodgers Jennifer
National Health Service Forth Valley, Stirling, Scotland.
Evid Based Dent. 2008;9(1):9-10. doi: 10.1038/sj.ebd.6400561.
A cluster randomised controlled trial (RCT) was carried out.
Twice-yearly applications of fluoride varnish were made in a test group of children from relatively deprived areas, with a similar no-intervention control group. The test and control children were from two school years (aged 6-8 years) from 24 state primary schools in the Manchester area. Fluoride varnish was applied five times at school over a period of 26 months by dental hygienists.
Caries increment indicated by decayed, missing or filled teeth in the primary (dmft) or permanent dentition (DMFT)was measured.
A total of 2091 children in 24 schools were eligible for inclusion in the study. No response was received from 1023 children, 154 did not consent and 914 gave positive consent. Of those giving positive consent, 457 were randomly allocated to the test group and 457 to the control group. During the study, 263 children in the test group received five varnish applications and 319 received four or more applications. At baseline there were no important differences in caries levels of participants in the test and control groups. At the final examination there was only one statistically significant difference in the caries increment, for small enamel lesions only in the primary dentition, with the test children having fewer lesions. This was not, however, apparent for the other levels of caries diagnosis, nor for all three levels of caries diagnosis in the permanent dentition.
The results of this study suggest that the use of this type of fluoride varnish intervention cannot be recommended as a public health measure for reducing caries in this population.
开展了一项整群随机对照试验（RCT）。
对来自相对贫困地区的一组儿童每半年应用一次含氟涂料，并设立了一个未进行干预的类似对照组。试验组和对照组儿童来自曼彻斯特地区24所公立小学的两个学年（6至8岁）。口腔保健员在26个月内于学校为儿童应用了5次含氟涂料。
测量乳牙（dmft）或恒牙（DMFT）中龋坏、缺失或充填牙所表明的龋病增量。
24所学校的2091名儿童符合纳入本研究的条件。1023名儿童未回复，154名不同意，914名给予了肯定同意。在给予肯定同意的儿童中，457名被随机分配至试验组，457名被分配至对照组。在研究期间，试验组263名儿童接受了5次涂料应用，319名接受了4次或更多次应用。基线时，试验组和对照组参与者的龋病水平无重要差异。在最终检查时，仅在乳牙仅为小的釉质病变的龋病增量方面存在一个统计学上的显著差异，试验组儿童的病变较少。然而，在其他龋病诊断水平以及恒牙所有三个龋病诊断水平中均不明显。
本研究结果表明，不能推荐将这种含氟涂料干预措施作为该人群减少龋病的公共卫生措施。
