Medina Varela Andrea Fernanda, García Pérez Alvaro, Villanueva Gutiérrez Teresa, Mora Navarrete Karen Angelina, Nieto Sánchez Martha Patricia
Pediatric Stomatology Specialties, Faculty of Higher Studies (FES) Iztacala, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
Laboratory of Public Health Research, Faculty of Higher Studies (FES), Iztacala, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
PLoS One. 2024 Sep 16;19(9):e0310420. doi: 10.1371/journal.pone.0310420. eCollection 2024.
To evaluate the association between the frequency and severity of dental fluorosis and Molar Incisor Hypomineralization (MIH) in 8-12-year-old schoolchildren living in an area with a high concentration of fluoride in the drinking water.
The present cross‑sectional study was conducted on Mexican children (n = 573) selected from one community presenting a drinking water fluoride concentration of 1.39 ppm/F. The prevalence of dental fluorosis was ascertained using the Thylstrup and Fejerskov Index (TFI). The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using the severity of MIH as the result.
The prevalence of MIH was 37.7% and, by severity, was 16.1% mild, 14.3% moderate, and 7.3% severe. The prevalence of dental fluorosis in permanent dentition was 70.9% (TFI ≥1) and, by severity, was 29.2% (TFI = 0), 45.6% (TFI 1-3) and 25.3% (TFI ≥4), while 54.5% of subjects were found to have poor oral hygiene. Schoolchildren with fluorosis (TFI ≥4) were 49% less likely [OR = 0.51; p = 0.025] to present mild MIH than children with fluorosis (TFI <4). Similarly, children with fluorosis (TFI ≥4) were 53% [OR = 0.47; p = 0.019] and 62% [OR = 0.38; p = 0.036] less likely to present moderate and severe MIH than children with fluorosis (TFI <4).
An inverse relationship between the presence of fluorosis and MIH was found. The results obtained by the present study may contribute to both the early identification of disorders affecting the enamel and the creation and implementation of long-term oral health prevention, promotion, and intervention programs in the affected population.
评估生活在饮用水氟含量高的地区的8至12岁学童中氟斑牙的频率和严重程度与恒磨牙-恒前磨牙矿化不全（MIH）之间的关联。
本横断面研究针对从一个饮用水氟浓度为1.39 ppm/F的社区中选取的墨西哥儿童（n = 573）开展。使用蒂尔斯楚普和费耶斯科夫指数（TFI）确定氟斑牙的患病率。使用欧洲儿童牙科学会（EAPD）标准评估MIH的存在情况和严重程度。以MIH的严重程度为结果，采用多项回归模型估计比值比（OR）和95%置信区间（CI）。
MIH的患病率为37.7%，按严重程度划分，轻度为16.1%，中度为14.3%，重度为7.3%。恒牙列中氟斑牙的患病率为70.9%（TFI≥1），按严重程度划分，TFI = 0为29.2%，TFI 1 - 3为45.6%，TFI≥4为25.3%，同时发现54.5%的受试者口腔卫生较差。与氟斑牙程度较轻（TFI <4）的儿童相比，氟斑牙程度较重（TFI≥4）的学童出现轻度MIH的可能性低49%[OR = 0.51；p = 0.025]。同样，与氟斑牙程度较轻（TFI <4）的儿童相比，氟斑牙程度较重（TFI≥4）的儿童出现中度和重度MIH的可能性分别低53%[OR = 0.47；p = 0.019]和62%[OR = 0.38；p = 0.036]。
发现氟斑牙的存在与MIH之间存在负相关关系。本研究获得的结果可能有助于早期识别影响牙釉质的疾病，并有助于在受影响人群中制定和实施长期口腔健康预防、促进及干预项目。
