Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Department of Applied Clinical Research and Dental Public Health, Cardiff University School of Dentistry, Cardiff, UK.
Community Dent Oral Epidemiol. 2018 Oct;46(5):492-499. doi: 10.1111/cdoe.12407. Epub 2018 Jul 18.
To assess the prevalence and severity of dental fluorosis and caries among Malaysian children following the reduction in fluoride concentration from 0.7 to 0.5 parts per million (ppm) in the public water supply.
This study involved lifelong residents aged 9- and 12-year-olds in fluoridated and nonfluoridated areas in Malaysia (n = 1155). In the fluoridated area, children aged 12 years and 9 years were exposed to 0.7 and 0.5 ppm, respectively, at the times when maxillary central incisors developed. Standardized photographs of maxillary central incisors were blind scored for fluorosis using Dean's criteria. Dental caries was examined using ICDAS-II criteria.
The prevalence of fluorosis (Dean's score ≥ 2) among children in the fluoridated area (35.7%, 95% CI: 31.9%-39.6%) was significantly higher (P < 0.001) than children in the nonfluoridated area (5.5%, 95% CI: 3.6%-7.4%). Of those in the fluoridated area, the prevalence of fluorosis decreased from 38.4% (95% CI: 33.1%-44.3%) for 12-year-olds to 31.9% (95% CI: 27.6%-38.2%) for 9-year-olds, although this difference was not statistically significant (P = 0.139). The mean caries experience in the permanent dentition was significantly lower in the fluoridated area than in the nonfluoridated area for both age groups (P < 0.05). In the multivariate models, the difference in the differences of caries experience between fluoridated and nonfluoridated areas remained statistically significant. This suggests that caries-preventive effect is still maintained at 0.5 ppm.
Findings indicate that the change in fluoride level from 0.7 to 0.5 ppm has reduced fluorosis and maintains a caries-preventive effect. Although there is a reduction in fluorosis prevalence, the difference was not statistically significant.
评估马来西亚儿童在公共供水氟浓度从 0.7 降至 0.5 百万分率（ppm）后氟斑牙和龋齿的流行程度和严重程度。
本研究涉及马来西亚氟化物和非氟化物地区终身居住的 9 岁和 12 岁儿童（n=1155）。在氟化物地区，12 岁和 9 岁儿童的上颌中切牙萌出时分别暴露于 0.7 和 0.5ppm。使用 Dean 标准对上颌中切牙的标准照片进行盲法氟斑牙评分。使用 ICDAS-II 标准检查龋齿。
氟化物地区（Dean 评分≥2）儿童的氟斑牙患病率（35.7%，95%CI：31.9%-39.6%）明显高于非氟化物地区（5.5%，95%CI：3.6%-7.4%）（P<0.001）。在氟化物地区，12 岁儿童的氟斑牙患病率从 38.4%（95%CI：33.1%-44.3%）下降到 9 岁儿童的 31.9%（95%CI：27.6%-38.2%），尽管差异无统计学意义（P=0.139）。两组年龄组恒牙列的平均龋齿患病情况在氟化物地区均明显低于非氟化物地区（P<0.05）。在多变量模型中，氟化物地区和非氟化物地区龋齿患病情况差异的差异仍然具有统计学意义。这表明在 0.5ppm 时仍保持着防龋效果。
研究结果表明，氟水平从 0.7 降至 0.5ppm 降低了氟斑牙的患病率并保持了防龋效果。尽管氟斑牙的患病率有所下降，但差异无统计学意义。
