Seppä L, Kärkkäinen S, Hausen H
Institute of Dentistry, University of Oulu, Finland.
Community Dent Oral Epidemiol. 1998 Aug;26(4):256-62. doi: 10.1111/j.1600-0528.1998.tb01959.x.
The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992.
The aim of this study was to examine the consequences of the discontinuation on dental health.
In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyväskylä, a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns.
In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12- and 15-year-olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined.
These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics.
芬兰库奥皮奥的自来水于1959年开始进行氟化处理。由于不同市民团体的强烈反对,1992年底停止了水氟化处理。
本研究旨在调查停止水氟化处理对牙齿健康的影响。
1992年和1995年,从库奥皮奥和于韦斯屈莱抽取了所有6岁、9岁、12岁和15岁儿童的独立随机样本,于韦斯屈莱是附近一个低氟城镇,其人口和社会经济特征分布与库奥皮奥相当相似。1992年检查的受试者总数为550人,1995年为1198人。两个城镇的龋齿均由同两位经过校准的牙医进行临床和影像学记录。
1992年,在两个年龄较大的年龄组中,氟化处理城镇的平均DMFS值较低,12岁和15岁儿童的百分比差异分别为37%和29%。对于两个年龄较小的年龄组,未发现有意义的差异。1995年,唯一可能具有临床意义的差异出现在15岁儿童中,有利于氟化处理城镇(18%)。1995年,非氟化处理城镇的两个年龄较大的年龄组龋齿出现下降。尽管停止了水氟化处理,但在库奥皮奥未发现龋齿增加趋势的迹象。1992年至1995年期间,两个城镇的氟化物漆和窝沟封闭剂的平均应用次数均大幅下降。尽管如此,龋齿仍有所下降。
这些发现表明,龋齿的下降与牙科诊所实施的专业预防措施关系不大。