Int Dent J. 1984 Jun;34(2):141-58.
The use of effective preventive methods has produced good results in developed countries, where caries is declining and periodontal disease is probably getting no worse. There are special problems with prevention in developing countries, principally high periodontal disease prevalence, rising caries rates and lack of resources to deal with these problems. With appropriate assistance, much can still be accomplished in these developing countries. Depending on economic resources and disease patterns, the following procedures for oral disease prevention can be recommended. Priority order will vary from country to country, and national and local laws may also determine what procedures can or cannot be employed. Fluoridation of water supplies is the most effective action to prevent caries in communities where piped water supplies are in place. It is relatively cheap and does not depend on individual action. Where water fluoridation is not feasible, community-based alternatives are salt fluoridation, school-water fluoridation or supervised ingestion of fluoride supplements. Supervised mouthrinsing with fluoride solutions, usually in schools, is effective in fluoridated and non-fluoridated communities. Dentists or auxiliaries can also apply fluoride gels or solutions to the teeth of individual patients. The use of fluoride toothpastes is recommended wherever possible as a routine part of self care. All preventive activities have an educational component. Community leaders and others should be educated regarding the institution and maintenance of community preventive measures which affect them. Individual patients should be educated regarding their oral hygiene, use of fluoride, restriction of sugary snacks between meals and the necessity for regular dental visits when services are available. Dental health education of the public can be concentrated in special target groups such as expectant mothers. Because dental caries is a public health problem in many countries, public policy to control the availability of highly cariogenic foods should be considered. Fissure sealants, when applied properly, are highly effective in preventing caries in occlusal surfaces. Their use is recommended on newly erupted teeth in susceptible persons, and they may be specially useful in the handicapped. Trained operators are required and the procedure is reasonably expensive; these factors may restrict the use of sealants where resources are limited. The ability of the individual patient to control plaque by toothbrushing, flossing or chewsticks should be developed to the utmost as the first step in controlling periodontal disease. 2+.
在发达国家，采用有效的预防方法已取得良好效果，在这些国家，龋齿发病率正在下降，牙周疾病可能也没有恶化。发展中国家的预防工作存在一些特殊问题，主要是牙周疾病患病率高、龋齿发病率上升以及缺乏应对这些问题的资源。在适当的援助下，这些发展中国家仍能取得很大成效。根据经济资源和疾病模式，可推荐以下口腔疾病预防措施。优先顺序因国家而异，国家和地方法规也可能决定哪些措施可以或不可以采用。在有管道供水的社区，对供水进行氟化处理是预防龋齿最有效的措施。这相对便宜，且不依赖个人行动。在无法进行水氟化处理的地方，基于社区的替代方法有盐氟化、学校水氟化或监督服用氟补充剂。通常在学校进行的用氟溶液监督漱口，在有氟和无氟社区都有效。牙医或辅助人员也可将氟凝胶或溶液应用于个别患者的牙齿。尽可能推荐使用含氟牙膏作为日常自我护理的一部分。所有预防活动都有教育内容。应就影响社区的预防措施的设立和维持，对社区领袖及其他人进行教育。应就个人口腔卫生、氟的使用、限制餐间含糖零食以及在有服务时定期看牙的必要性，对个别患者进行教育。对公众的口腔健康教育可集中在特殊目标群体，如孕妇。由于龋齿在许多国家都是公共卫生问题，应考虑制定控制高致龋性食物供应的公共政策。窝沟封闭剂如果应用得当，对预防咬合面龋齿非常有效。建议对易感人群新萌出的牙齿使用窝沟封闭剂，对残疾人可能特别有用。需要训练有素的操作人员，且该程序成本较高；这些因素可能会限制资源有限地区窝沟封闭剂的使用。应最大限度地培养患者通过刷牙、使用牙线或嚼棒控制牙菌斑的能力，这是控制牙周疾病的第一步。2+
