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.
J Public Health Dent. 2021 Dec;81(4):270-279. doi: 10.1111/jphd.12448. Epub 2021 Feb 25.
To determine the prevalence of dental fluorosis, and factors associated with its occurrence in two cohorts of children exposed to different fluoride concentrations in the Malaysian water supply.
A cross-sectional study was conducted among lifelong residents (n = 1,155) aged 9 and 12 years old living in fluoridated and nonfluoridated areas. Malaysian children aged 12 years were born when the level of fluoride in the public water supply was 0.7 ppm while those aged 9 years were born after the level was reduced to 0.5 ppm. Fluorosis was blind scored using standardized photographs of maxillary central incisors using Dean's criteria. Fluoride exposures and other factors were assessed by parental questionnaire. Data were analyzed using descriptive statistics, Chi-squared analyses, and logistic regression.
Fluorosis prevalence was lower (31.9 percent) among the younger children born after the reduction of fluoride concentration in the water, compared to a prevalence of 38.4 percent in the older cohort. Early tooth brushing practices and fluoridated toothpaste were not statistically associated with fluorosis status. However, the prevalence of fluorosis was significantly associated with parents' education level, parents' income, fluoridated water, type of infant feeding method, age breast feeding ceased, use of formula milk, duration of formula milk intake, and type of water used to reconstitute formula milk via simple logistic regression. Fluoridated water remained a significant risk factor for fluorosis in multiple logistic regression.
Fluorosis was lower among children born after the adjustment of fluoride concentration in the water. Fluoridated water remained as a strong risk factor for fluorosis after downward adjustment of its fluoride concentration.
确定在马来西亚供水系统中暴露于不同氟化物浓度的两个队列儿童中氟斑牙的流行率及其相关因素。
在氟化物处理区和非氟化物处理区进行了一项横断面研究，研究对象为终生居住的 9 岁和 12 岁儿童（n=1155）。12 岁的马来西亚儿童出生时，公共供水系统中的氟化物水平为 0.7ppm，而 9 岁的儿童出生时，氟化物水平已降至 0.5ppm。使用 Dean 标准对上颌中切牙的标准照片进行盲法评分，以评估氟斑牙程度。氟化物暴露和其他因素通过父母问卷进行评估。使用描述性统计、卡方分析和逻辑回归分析数据。
与年龄较大的队列相比，出生在水中氟化物浓度降低后的较小年龄组的儿童（31.9%）氟斑牙患病率较低。早期刷牙习惯和含氟牙膏与氟斑牙状况无统计学关联。然而，氟斑牙的患病率与父母的教育程度、父母的收入、氟化物水、婴儿喂养方式、母乳喂养停止年龄、使用配方奶、配方奶摄入持续时间以及用于重新配制配方奶的水类型显著相关。通过简单逻辑回归，氟化物水仍然是氟斑牙的重要危险因素。氟化物水在多变量逻辑回归中仍然是氟斑牙的重要危险因素。
水中氟化物浓度调整后出生的儿童中氟斑牙患病率较低。即使向下调整其氟化物浓度，氟化物水仍然是氟斑牙的强烈危险因素。
