Department of Preventive and Community Dentistry Darshan Dental College and Hospital Udaipur, Rajasthan, India.
Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e547-53. doi: 10.4317/medoral.14.e547.
To assess the influence of the water fluoride level on periodontal status, by determining the periodontal health status of subjects residing in low, optimum and high fluoride areas.
A cross sectional survey was carried out on 967 adults aged 35-44 years old, from the Udaipur district of India. A stratified cluster random sampling technique was implemented in order to collect a representative sample from low (<0.6 ppm), optimum (0.6 - 1.2 ppm) and high fluoride (>3 ppm) areas, based on the fluoride concentration in drinking water. Periodontal status was assessed in accordance to WHO criteria. The Chi-square test was used to compare proportions, and logistic regression analysis was used to determine the contribution of water fluoride levels to periodontal disease.
Those residing in areas of low fluoride levels were more likely to present periodontal pockets than those living in high fluoride areas 1.3 (95 % CI 1.11+/-1.86). Subjects living in areas of low fluoride were noted to have a higher risk of periodontal attachment loss of more than 8mm (OR = 1.94, 95% CI 1.67+/-3.85). The risk for presence of periodontal pockets and attachment loss of more than 8mm increased by 1.17 (95 % CI 1.02+/-1.69) and 1.59 (95 % CI 1.27+/-3.29) respectively for those residing in areas of optimum fluoride levels. Deep periodontal pockets were more prevalent (6.3%) among those residing in areas of low fluoride, followed by optimum (5.2%) and high (3.1%).
As the fluoride concentrations increased, the prevalence of shallow and deep periodontal pockets decreased. The severity of periodontal disease was significantly associated with fluoride levels, with cases of loss of attachment gradually decreasing when moving from low fluoride areas to high fluoride areas. It appears that longitudinal studies need to be conducted in order to ascertain the benefits; and microbiological analysis of dental plaque and periodontium should be carried out in order to confirm the effects of fluoride on periodontal conditions.
通过确定居住在低氟、适氟和高氟地区人群的牙周健康状况，评估水氟水平对牙周状况的影响。
在印度乌代浦地区，对 967 名 35-44 岁成年人进行了横断面调查。采用分层聚类随机抽样技术，根据饮用水中的氟浓度，从低氟(<0.6ppm)、适氟(0.6-1.2ppm)和高氟(>3ppm)地区采集代表性样本。根据世界卫生组织标准评估牙周状况。采用卡方检验比较比例，采用逻辑回归分析确定水氟水平对牙周病的贡献。
与居住在高氟地区的人群相比，居住在低氟地区的人群更容易出现牙周袋，比值比为 1.3(95%置信区间 1.11+/-1.86)。低氟地区的人群更容易出现牙周附着丧失>8mm的情况，比值比为 1.94(95%置信区间 1.67+/-3.85)。居住在适氟地区的人群，出现牙周袋和附着丧失>8mm的风险分别增加了 1.17(95%置信区间 1.02+/-1.69)和 1.59(95%置信区间 1.27+/-3.29)。低氟地区人群深牙周袋的患病率(6.3%)较高，其次是适氟地区(5.2%)和高氟地区(3.1%)。
随着氟浓度的增加，浅牙周袋和深牙周袋的患病率逐渐降低。牙周病的严重程度与氟水平显著相关，从低氟地区到高氟地区，附着丧失的病例逐渐减少。似乎需要进行纵向研究以确定氟的益处；并对牙菌斑和牙周组织进行微生物分析，以确认氟对牙周状况的影响。
