Hawley G M, Ellwood R P, Davies R M
Dental Health Unit, University of Manchester, UK.
Community Dent Health. 1996 Dec;13(4):189-92.
The aims of this study were to determine the opinions of a group of adolescents about the cosmetic acceptability of a range of fluorosis, investigate the prevalence and severity of fluorosis in the sample and consider the extent to which fluorosis levels were related to their dental caries experience. A random sample of 534 14-year-old pupils from the non-fluoridated industrial city of Manchester were examined for caries and fluorosis. Each subject then examined six photographs of upper anterior teeth showing a range of TF scores 0-4 and were asked to rate the appearance of each as either very poor, poor, acceptable, good or very good and to indicate whether they would request treatment if their teeth were so affected. Four hundred and seventy-six subjects (89 per cent) had TF scores of 0. Of the 58 subjects (11 per cent) with fluorosis, 27 (5 per cent) scored TF = 1; 22 (4 per cent) TF = 2; 7 (1 per cent) TF = 3 and one subject scored TF = 4. The subjects who had no fluorosis had a mean DMFT of 3.0 which was significantly higher than the mean of 2.2 among those with any fluorosis. The proportion of subjects who rated the photographs as poor or very poor fell from 29 per cent for TF score 0 to 15 per cent for TF score 2 and then increased to 92 per cent for TF score 3. The responses of the subjects regarding their desire for treatment matched closely with their opinions on appearance; the majority of subjects expressed concern over the appearance of teeth with TF scores of 3 and higher. It is concluded that the prevalence of aesthetically objectionable dental fluorosis was low and that mild fluorosis was associated with a lower risk of dental caries and a more acceptable appearance. It is essential that a balanced view of the relative benefits and risks of the use of fluorides is maintained and proven benefits are not overwhelmed by largely unfounded aesthetic concerns.
本研究的目的是确定一组青少年对一系列氟斑牙美观可接受性的看法，调查样本中氟斑牙的患病率和严重程度，并考虑氟斑牙水平与其龋齿经历的相关程度。对来自非氟化工业城市曼彻斯特的534名14岁学生进行随机抽样，检查其龋齿和氟斑牙情况。然后，每位受试者查看六张上前牙照片，这些照片显示了0至4的一系列TF评分，并被要求将每张照片的外观评为非常差、差、可接受、好或非常好，并指出如果他们的牙齿受到如此影响是否会要求治疗。476名受试者（89%）的TF评分为0。在58名（11%）有氟斑牙的受试者中，27名（5%）的TF评分为1；22名（4%）的TF评分为2；7名（1%）的TF评分为3，一名受试者的TF评分为4。没有氟斑牙的受试者平均DMFT为3.0，显著高于有任何氟斑牙的受试者的平均值2.2。将照片评为差或非常差的受试者比例从TF评分为0时的29%降至TF评分为2时的15%，然后升至TF评分为3时的92%。受试者对治疗的渴望反应与他们对外观的看法密切匹配；大多数受试者对TF评分为3及以上的牙齿外观表示担忧。结论是，美学上令人反感的氟斑牙患病率较低，轻度氟斑牙与较低的龋齿风险和更可接受的外观相关。必须对使用氟化物的相对益处和风险保持平衡的看法，并且已证实的益处不应被基本上毫无根据的美学担忧所掩盖。
