Šket Tea, Kukec Andreja, Kosem Rok, Artnik Barbara
University of Ljubljana, Faculty of Medicine, Department of Public Health, Zaloška 4, 1000 Ljubljana, Slovenia.
University Medical Centre Ljubljana, Dental Clinic, Hrvatski trg 6, 1000 Ljubljana, Slovenia.
Zdr Varst. 2017 Feb 26;56(2):140-146. doi: 10.1515/sjph-2017-0018. eCollection 2017 Jun 1.
The aim of our study was to chronologically analyse various public health measures of fluoride use in caries prevention.
We systematically searched the PubMed database on the preventive role of fluorides in public health, published from 1984 to 2014. The search process was divided into four steps, where inclusion and exclusion criteria were defined. Qualitative methodology was used for the article analysis. In the research process, the described forms of F use, diversity of the described F agents, and the observed population group were analysed.
In our systematic review, 40 relevant reviews were revealed. Fluorides have been used in many different forms, but only a few studies showed their significant role in public health. Water fluoridation was the most important public health measure. In the recent decades, the number of studies on topical fluorides is constantly rising. The most extensively described topical forms of fluorides are professionally applied fluoride agents and fluoride toothpaste for home-use. The use of fluoride containing toothpaste in caries prevention is a safe and successful public health measure (PHM) if their use is widespread, and it is recommended for all. The results on other topical forms of fluorides are insufficient to be suggested as an important PHM.
The role of fluorides in public health prevention has changed in accordance with the knowledge about the fluoride cariostatic mechanism. Previously the most important pre-eruptive effect of fluorides was supplemented by the post eruptive effect. Abundant evidence exists to show the effectiveness of systemic and topical fluorides.
我们研究的目的是按时间顺序分析预防龋齿中使用氟化物的各种公共卫生措施。
我们系统检索了1984年至2014年发表的关于氟化物在公共卫生中预防作用的PubMed数据库。检索过程分为四个步骤，其中定义了纳入和排除标准。采用定性方法进行文章分析。在研究过程中，分析了所描述的氟化物使用形式、所描述的氟化物制剂的多样性以及观察到的人群组。
在我们的系统评价中，共检索到40篇相关综述。氟化物有多种不同的使用形式，但只有少数研究表明其在公共卫生中的显著作用。饮水加氟是最重要的公共卫生措施。近几十年来，关于局部用氟化物的研究数量不断增加。最广泛描述的局部用氟化物形式是专业应用的氟化物制剂和家用含氟牙膏。如果广泛使用含氟牙膏预防龋齿，那么它是一种安全且成功的公共卫生措施，建议所有人使用。关于其他局部用氟化物形式的结果不足以将其作为重要的公共卫生措施推荐。
根据对氟化物防龋机制的认识，氟化物在公共卫生预防中的作用发生了变化。以前氟化物最重要的萌出前作用得到了萌出后作用的补充。有充分证据表明全身用氟化物和局部用氟化物的有效性。
