Spencer A J, Slade G D, Davies M
Australian Institute of Health and Welfare, University of Adelaide, Australia.
Community Dent Health. 1996 Sep;13 Suppl 2:27-37.
This paper reviews the rationale, context and support for water fluoridation in Australia, and examines current Australian evidence concerning the caries-preventive effects of fluoridation and trends in dental fluorosis. Nearly two thirds of the Australian population resides in an area with adjusted levels of fluoride in the water supply. However, public knowledge about fluoridation is poor and opinion polls demonstrate declining support for fluoridation. In the press and scientific literature there has been questioning of fluoridation, although the most recent Australian review reasserted its safety and effectiveness. Results from Australian oral epidemiological studies consistently support the accumulated evidence on the effectiveness of water fluoridation. This includes recent evidence that lifetime exposure to fluoridation is associated with average reductions of 2.0 dmfs and between 0.12 and 0.30 DMFS per child compared with non-exposed children. Water fluoridation has been found to reduce socio-economic inequalities in caries, reducing the differential between high and low socio-economic status groups by approximately 1.0 dmfs and 0.2 DMFS per child. The prevalence of dental fluorosis may have increased, prompting renewed consideration of overall exposure to fluorides. Action is currently being taken to reduce the exposure to discretionary fluoride among pre-school children as part of a targeted approach to adjusting the benefit-risk relationship of exposure to fluorides for that age group. Community water fluoridation continues to be the most effective and socially equitable measure for caries prevention among all ages by achieving community-wide exposure to the caries preventive effects of fluoride.
本文回顾了澳大利亚实施水氟化的基本原理、背景和支持情况，并审视了澳大利亚目前关于氟化预防龋齿效果及氟斑牙趋势的证据。近三分之二的澳大利亚人口居住在供水氟含量经过调整的地区。然而，公众对水氟化的了解甚少，民意调查显示对水氟化的支持率在下降。在媒体和科学文献中，有人对水氟化提出质疑，尽管澳大利亚最近的综述重申了其安全性和有效性。澳大利亚口腔流行病学研究结果一直支持关于水氟化有效性的累积证据。这包括最近的证据表明，与未接触水氟化的儿童相比，终生接触水氟化的儿童平均每人的乳牙龋失补牙面数（dmfs）减少2.0，恒牙龋失补牙面数（DMFS）减少0.12至0.30。已发现水氟化可减少龋齿方面的社会经济不平等现象，使社会经济地位高和低的群体之间的差异每名儿童减少约1.0 dmfs和0.2 DMFS。氟斑牙的患病率可能有所上升，这促使人们重新考虑氟化物的总体接触情况。目前正在采取行动减少学龄前儿童的非必要氟化物接触，作为调整该年龄组氟化物接触利弊关系的有针对性方法的一部分。社区水氟化通过使社区范围内的人接触到氟化物的防龋效果，仍然是各年龄段预防龋齿最有效且社会公平的措施。
