Siegal M D, Farquhar C L, Bouchard J M
Bureau of Oral Health Services, Ohio Department of Health, Columbus 43266-0588, USA.
Public Health Rep. 1997 Mar-Apr;112(2):98-106; discussion 107.
Most childhood tooth decay is preventable with a combination of fluoride--which protects the smooth surfaces of a tooth--and dental sealants--which protect tooth surfaces with irregularities called pits and fissures. Sealants are plastic coatings that protect these vulnerable areas, often narrower than a single toothbrush bristle, from decay-causing bacteria and food in the mouth. Yet, 1988-1991 data from the National Health and Nutrition Examination Survey showed that while many children still had cavities, over 80% of which were related to pits and fissures, relatively few children had sealants applied to permanent teeth. As caries has gone from a ubiquitous disease to one affecting only half of children in early elementary school and two-thirds of those who are 15 years of age, dentists must consider how to best target sealants to individual children who are at greatest risk for new disease. Most sealants are placed in private dental offices, but children at greatest risk for problems resulting from tooth decay are least likely to get private care. State and local health departments, therefore, have gone after hard-to-reach children and adolescents through school-based and school-linked sealant programs, often using portable dental equipment. This article focuses on public health strategies for community-based prevention.
大多数儿童龋齿是可以预防的，方法是结合使用氟化物（保护牙齿的光滑表面）和牙齿封闭剂（保护有称为窝沟的不规则表面的牙齿）。封闭剂是一种塑料涂层，可保护这些通常比单根牙刷刷毛还窄的脆弱区域免受口腔中致龋细菌和食物的侵害。然而，1988 - 1991年全国健康和营养检查调查的数据显示，虽然许多儿童仍有龋齿，其中超过80%与窝沟有关，但相对较少的儿童在恒牙上使用了封闭剂。由于龋齿已从一种普遍存在的疾病转变为仅影响小学低年级一半儿童和15岁儿童三分之二的疾病，牙医必须考虑如何最好地针对那些患新疾病风险最高的个体儿童使用封闭剂。大多数封闭剂是在私人牙科诊所放置的，但因龋齿导致问题风险最高的儿童获得私人护理的可能性最小。因此，州和地方卫生部门通过基于学校和与学校相关的封闭剂项目，通常使用便携式牙科设备，来关注那些难以接触到的儿童和青少年。本文重点关注基于社区预防的公共卫生策略。
