Mascarenhas A K, Burt B A
Section of Health Services Research, College of Dentistry, Ohio State University, Columbus, USA.
Community Dent Oral Epidemiol. 1998 Aug;26(4):241-8. doi: 10.1111/j.1600-0528.1998.tb01957.x.
Swallowed fluoride toothpaste in the early years of life has been postulated to be a risk factor for fluorosis, but the epidemiological evidence is weakened by the fact that most of the relevant studies were done in developed countries where an individual is exposed to multiple sources of fluoride.
To quantify the risk of fluorosis from fluoride toothpaste in a population whose only potential source of fluoride was fluoride toothpaste.
Case-control analyses were conducted to test the hypothesis that fluoride toothpaste use before the age of 6 years increased an individual's risk of fluorosis. Data came from a cross-sectional clinical dental examination of schoolchildren and a self-administered questionnaire to their parents. The study was conducted in Goa, India. The study group consisted of 1189 seventh grade children with a mean age of 12.2 years.
The prevalence of fluorosis was 12.9% using the TF index. Results of the crude, stratified, and logistic regression analyses showed that use of fluoride toothpaste before the age of 6 years was a risk indicator for fluorosis (OR 1.83, 95% CI 1.05-3.15). Among children with fluorosis, beginning brushing before the age of 2 years increased the severity of fluorosis significantly (P<0.001). Other factors associated with the use of fluoride toothpaste, such as eating or swallowing fluoride toothpaste and higher frequency of use, did not show a statistically significant increased risk for prevalence or severity of fluorosis.
Fluoride toothpaste use before the age of 6 years is a risk indicator for fluorosis in this study population.
早年吞咽含氟牙膏被认为是氟斑牙的一个风险因素，但大多数相关研究是在发达国家进行的，在这些国家个人接触多种氟来源，这一事实削弱了流行病学证据。
在一个唯一潜在氟来源是含氟牙膏的人群中，量化含氟牙膏导致氟斑牙的风险。
进行病例对照分析，以检验6岁前使用含氟牙膏会增加个体患氟斑牙风险这一假设。数据来自对学童的横断面临床牙科检查以及向其父母发放的自填式问卷。该研究在印度果阿进行。研究组由1189名七年级儿童组成，平均年龄12.2岁。
使用TF指数时，氟斑牙患病率为12.9%。粗分析、分层分析和逻辑回归分析结果显示，6岁前使用含氟牙膏是氟斑牙的一个风险指标（比值比1.83，95%可信区间1.05 - 3.15）。在患氟斑牙的儿童中，2岁前开始刷牙显著增加了氟斑牙的严重程度（P<0.001）。与使用含氟牙膏相关的其他因素，如进食或吞咽含氟牙膏以及更高的使用频率，在氟斑牙患病率或严重程度方面未显示出统计学上显著增加的风险。
在本研究人群中，6岁前使用含氟牙膏是氟斑牙的一个风险指标。
