Cutress T W, Suckling G W
Dental Research Unit, Medical Research Council of New Zealand, Wellington.
J Dent Res. 1990 Feb;69 Spec No:714-20; discussion 721. doi: 10.1177/00220345900690S138.
Differentiating between fluorotic and non-fluorotic defects of dental enamel is an important diagnostic decision in epidemiology and public health dentistry. The commonly accepted diagnostic criteria for fluorosis discriminate between non-discrete symmetrical and asymmetrical distributions of opacities of dental enamel. These criteria appear to identify most cases of dental fluorosis. However, it is not yet confirmed that the pattern and distribution of dental fluorosis are a unique phenomenon. Metabolic, physiological, other trace elements, and malnutrition have been reported to induce bilateral symmetrical developmental enamel opacities. Misdiagnosis of non-fluoride-induced opacities remains a possibility. Reports of unexpectedly high population prevalence and individual cases of fluorosis, where such diagnoses are incompatible with the known fluoride history, indicate the need for a more precise definition and diagnosis of dental fluorosis. A more discriminating diagnostic procedure is recommended. This calls for a positive identification of the levels of fluoride available to communities and individuals before a diagnosis of fluorosis is confirmed. We believe a more critical approach to the diagnosis of fluorosis will be helpful in the rational use and control of fluorides for dental health, and in the identification of factors associated with inducing developmental defects of enamel.
区分牙釉质氟斑和非氟斑缺陷是流行病学和公共卫生牙科学中一项重要的诊断决策。目前普遍接受的氟斑诊断标准是根据牙釉质不透明区域的非离散性对称和不对称分布来区分的。这些标准似乎能识别出大多数氟斑病例。然而，牙釉质氟斑的形态和分布是否为独特现象尚未得到证实。据报道，代谢、生理、其他微量元素以及营养不良均可导致双侧对称性牙釉质发育不透明。非氟化物诱导的牙釉质不透明仍有可能被误诊。一些报告显示，在某些氟斑诊断与已知的氟化物接触史不符的情况下，人群患病率和个体病例的氟斑率却意外地高，这表明需要对牙釉质氟斑进行更精确的定义和诊断。建议采用更具区分性的诊断程序。这就要求在确诊氟斑之前，先明确社区和个体可接触到的氟化物水平。我们认为，对氟斑诊断采取更严谨的方法将有助于合理使用和控制用于口腔健康的氟化物，并有助于识别与牙釉质发育缺陷相关的因素。
