Petersen P E, Kwan S, Ogawa H
Community Dent Health. 2015 Dec;32(4):199-203.
To determine the clinical effectiveness of a community milk fluoridation programme.
Parallel arm 5-year cohort study, with final cross-sectional comparisons between groups.
3-year-olds in 8 Bulgarian cities/towns entered the cohort study with random samples (n = 1,782) recruited at baseline in 2004. After 5 years in 2009 sub-samples (about 30%) of these now aged 8 were randomly selected in intervention sites for follow-up examination (n = 454); 276 controls were examined at the age 8 years. For cross-sectional comparisons, in 2004, 284 3-year-olds from control cities were baseline examined for caries, then 276 children at the age 8 years in 2009.
In six intervention communities: 1,498 examined children received 0.5 mg F in 100 or 200 ml school milk or yogurt provided each school day; a further 180 received non-fluoridated milk. In two control communities, fluoride was not added to 284 children's school milk.
Dental caries experience of primary, and permanent teeth.
For primary teeth, caries increments were 46% (p < 0.001) and 30% (p < 0.01) lower in the fluoridated milk groups compared with non-fluoridated milk groups in the intervention and control communities, respectively. For permanent teeth those reductions were 61% and 53% (p < 0.001). The cross-sectional comparisons of 8-year-olds showed significant changes in dental caries experience over time; in children consuming fluoridated milk the level of dmfs fell by 43% (2004 and 2009) against 11% in the control group. Among children consuming fluoridated milk the DMFS fell 68% against rising 3% in the controls.
Fluoridated milk delivered daily in schools in Bulgaria resulted in substantially lower caries development compared with children in schools receiving milk without added fluoride. The nation-wide experiences from milk fluoridation indicate that such a public health scheme can be effective to the global fight against dental caries of children.
确定社区牛奶氟化项目的临床效果。
平行组5年队列研究，最终对组间进行横断面比较。
保加利亚8个城市/城镇的3岁儿童进入队列研究，2004年基线时随机抽取样本（n = 1,782）。2009年，在干预地点随机抽取这些现已8岁儿童的子样本（约30%）进行随访检查（n = 454）；276名对照儿童在8岁时接受检查。为进行横断面比较，2004年对来自对照城市的284名3岁儿童进行龋齿基线检查，2009年对276名8岁儿童进行检查。
在6个干预社区，1498名接受检查的儿童每天在学校饮用的100或200毫升牛奶或酸奶中摄入0.5毫克氟；另有180名儿童饮用未加氟的牛奶。在2个对照社区，284名儿童的学校牛奶中未添加氟化物。
乳牙和恒牙的龋齿患病情况。
对于乳牙，与干预社区和对照社区中饮用未加氟牛奶的组相比，饮用加氟牛奶组的龋齿增量分别低46%（p < 0.001）和30%（p < 0.01）。对于恒牙，这些降幅分别为61%和53%（p < 0.001）。对8岁儿童的横断面比较显示，随着时间推移，龋齿患病情况有显著变化；饮用加氟牛奶的儿童中，dmfs水平下降了43%（2004年和2009年），而对照组下降了11%。在饮用加氟牛奶的儿童中，DMFS下降了68%，而对照组上升了3%。
与饮用未添加氟化物牛奶的学校儿童相比，保加利亚学校每日提供加氟牛奶导致龋齿发展显著减少。全国范围内牛奶氟化的经验表明，这样一项公共卫生计划对全球防治儿童龋齿可能有效。
