氟化物在预防龋病中的作用

1942年美国医师Dean报道，当水氟浓度为1．0mg／L时可以获得最大的防龋效果，而且氟牙症（dental fluorosis）的患病率处于最低水平。随后于1945年1月，美国在世界上第一个实施饮水氟化的公共卫生措施，由此引发了预防口腔医学界的一场革命。半个多世纪以来氟化物已在全世界广泛应用，使龋病的患病率显著下降。使用氟化物预防龋齿是20世纪预防口腔医学对人类最伟大的贡献。     

益生菌在儿童龋病防治中的应用

龋病的生态学理论认为,龋病的本质是生态失衡性疾病,需生态防治。益生菌疗法能调节口腔微生态的平衡,成为龋病防治的潜在新方法,在儿童龋病的防治研究中备受关注。本文就近年来益生菌应用于儿童龋病防治的相关研究作一综述。     

唾液氟浓度在龋病预防中的作用

本文就唾液氟化物浓度变化的影响因素,全身与局部用氟后唾液氟浓度的变化,以及唾液氟浓度在龋病预防中的作用等进行了综述。     

唾液氟浓度在龋病预防中的作用

本文就唾液氟化物浓度变化的影响因素、全身与局部用氟后唾液氟浓度的变化,以及唾液氟浓度在龋病预防中的作用等进行了综述。     

Er：YAG激光在龋病防治中的研究进展

龋病是影响人类口腔和全身健康的常见疾病,目前龋病的预防和治疗方法主要是应用氟化物及窝沟封闭和涡轮机机械去腐。铒钇铝石榴石(Er：YAG)激光是一种新型牙体硬组织激光,可以高效切割牙体硬组织,因其安全、无痛、微创而越来越受人们重视。本文就其在龋病预防和去腐备洞对牙髓的影响、微渗漏、粘接性等方面性能的研究进展作一综述。     

儿童龋病管理

龋病是临床上最为常见的儿童口腔疾病,儿童龋病在我国具有患病率高、治疗率低的特点。近年来,随着对龋病认识的日趋深化以及材料和技术的不断进步,儿童口腔医学不仅仅关注儿童龋病的治疗,开始更多地强调对其进行早期预防、诊断和干预,微创理念亦贯穿儿童龋病预防和诊疗的全过程。文章从对龋病发生发展的再认识出发,就儿童龋病风险评估和管理以及如何治疗儿童龋损做一介绍。     

儿童龋病管理

 龋病是临床上最为常见的儿童口腔疾病，儿童龋病在我国具有患病率高、治疗率低的特点。近年来，随着对龋病认识的日趋深化以及材料和技术的不断进步，儿童口腔医学不仅仅关注儿童龋病的治疗，开始更多地强调对其进行早期预防、诊断和干预，微创理念亦贯穿儿童龋病预防和诊疗的全过程。文章从对龋病发生发展的再认识出发，就儿童龋病风险评估和管理以及如何治疗儿童龋损做一介绍。     

银川市儿童青少年龋病患病趋势分析

的　分析银川市儿童青少年龋病患病的发展趋势及特点。方法　1990、1996和2001年采用WHO口腔 流行病学调查方法对银川市3岁、5岁、12岁和15岁的儿童青少年进行调查,记录龋均、龋面均和龋齿充填比率,并 进行统计分析。结果　1990~2001年,3岁、5岁和12岁儿童青少年的龋患呈下降趋势(P<0·01), 15岁青少年龋 患无明显变化;少部分儿童乳牙龋患严重;龋齿的充填比率较低。结论　随着口腔健康教育的开展,银川市儿童青 少年龋患呈下降趋势,但应加强对龋易感儿童的诊断、预防和早期治疗,提高龋齿充填比率。     

变异链球菌噬菌体在龋病防治中的研究进展

变异链球菌作为主要致龋病原菌之一,其在牙菌斑生物膜中的过度增殖,是龋病发生发展的重要原因。细菌病毒——噬菌体可特异性感染细菌并有效降解细菌生物膜,因此变异链球菌噬菌体可能用于防治龋病。基于噬菌体的疗法已在多个领域进行临床应用,但变异链球菌噬菌体在龋病中的应用仍处于探索阶段。本文对变异链球菌噬菌体在龋病防治方面的应用进行综述,旨在为龋病的临床预防工作提供新的思路。文献复习结果表明,活噬菌体制剂具有特异性强、亲和力高以及安全性良好的优点,但由于其结构较不稳定,可以通过冻干、喷雾干燥、添加稳定性增强剂等方式,或将噬菌体并入软膏、可生物降解聚合物基质或微粒中加工成较稳定的制剂,在一定程度上提高稳定性;噬菌体产生的裂解酶可以消化细菌细胞壁,从而释放组装好的噬菌体颗粒,其在裂解生物膜中也同样表现优异;通过噬菌体展示技术筛选出针对致龋病原体的抗原结合片段库,利用抗原结合片段的被动免疫也可达到防治龋病的目的。然而,噬菌体的宿主范围狭窄,因此在临床龋病防治工作中可以通过噬菌体联合传统治疗或其他药物使用,或使用多种噬菌体的鸡尾酒治疗。     

兰州市学龄前儿童龋病调查分析与防治对策

目的　了解兰州市幼儿园儿童龋患情况 ,为制定适合的幼儿园儿童口腔保健规划提供依据。方法　对西北师范大学幼儿园 357名 4～ 6岁儿童进行口腔健康检查 ,并作统计分析。结果　 4岁、5岁、6岁儿童患龋率分别为 52 .54%、69.44%、84.2 1 % ,其龋均分别为 1 .73、3.43、5.1 1 ,不同年龄组之间患龋率、龋均都有显著性差异 (P <0 .0 1 )。 4岁组乳上前牙患龋率最高 ,6岁组下颌乳磨牙患龋率最高。结论　乳牙龋齿患病随年龄而递增 ;幼儿园口腔预防保健工作的重点是低龄儿童 ,宜采取局部用氟及窝沟封闭为主的方法 ,同时加强口腔健康教育。     

Fluoride supplements and caries in a non-fluoridated child population

In Norway, there is no water fluoridation and little naturally occurring fluoride in drinking water. Fluoride toothpaste is used by 95% of the population and there is a long tradition of use of fluoride supplements. The purpose of this study was to analyse whether children who used fluoride toothpaste regularly and complied with the recommendations for use of fluoride supplements had less caries than other children at the age of 8 years. Most fluoride supplements sold in Norway are lozenge-type tablets, which allow for extended enamel exposure to fluoride. All children (n = 551) born in 1988 living in a suburban community in Norway were invited to participate. In those who participated (n = 470), caries was registered clinically and radiographically and parents provided data on use of supplements. Thirty-eight percent of the children had used fluoride supplements regularly during the period 0.5 to 4.0 years of age and 66% used supplements regularly at the age of 6 to 8 years. Multivariate analyses showed that the children complying with the recommendations for use of fluoride supplements during the period 0.5 to 4.0 years of age had lower caries experience (dmfs) and fewer decayed surfaces (ds) in primary teeth than other children. No significant associations were found between supplement use in childhood and caries prevalence (DMFS) or number of decayed surfaces (DS) in permanent teeth at the age of 8 years. Supplement use from 6 to 8 years of age was not associated with caries occurrence either in primary or in permanent teeth. Both mother's education and the quality of dental hygiene were inversely associated with caries occurrence.     

Fluoride varnish for caries prevention: comparisons with other preventive agents and recommendations for a community-based protocol

This paper reviews fluoride varnish (FV) literature to develop a community-based protocol for people with special needs or those who are caries susceptible. Safety, personnel and cost issues are discussed and existing NIH, CDC and WHO recommendations are presented. FV studies are assessed with respect to type of FV to use and frequency of application. FV is compared with studies using other caries preventive agents: 0.2% NaF mouthrinse, acidulated phosphate fluoride (APF) gel, dental sealants, water fluoridation and chlorhexidine. Because there are few FV studies among special need populations, conclusions are based on available literature and public health principles. If personnel are available, FV use is preferred to APF gel and may be preferable to 0.2% NaF mouthrinse. FV is more effective in optimally fluoridated communities. If many occlusal surfaces are at risk, sealants should be applied. Additional combinations and frequencies of preventive agents should be tested, especially for people with special needs and high caries risk adults.     

氟化泡沫防龋2年效果观察

目的　观察氟化泡沫对儿童恒牙龋的预防作用 ,比较氟化泡沫与氟化凝胶的防龋效果。方法　将武汉市两所小学 612名 6～ 7岁儿童分为氟化泡沫组、氟化凝胶组和对照组 ,每 6个月分别使用一次氟化泡沫和氟化凝胶 ,为期 2年。结果　与对照组相比 ,氟化泡沫组和氟化凝胶组光滑面新生龋面均降低率分别为 40 .74%和3 7.0 4% (P <0 .0 5 ) ;窝沟新生龋面均降低率分别为 4.3 5 %和 13 .0 4% ,但无统计学差异 (P >0 .0 5 ) ;氟化泡沫组与氟化凝胶组比较 ,其光滑面和窝沟新生龋面均均无显著差异 (P >0 .0 5 )。结论　氟化泡沫对光滑面龋有明显的预防作用 ,效果与氟化凝胶相似。     

应用氟化泡沫预防幼儿龋齿的防龋效果观察

目的：抽样调查东西湖区儿童使用氟化泡沫预防龋齿的效果。方法：对东西湖区8所幼儿园进行随机抽样,实验组儿童采用氟化泡沫护齿,每年2次,对照组儿童不做任何处理,2年后观察两组儿童之间患龋率及新龋发生率。结果：2年后实验组患龋率及新龋发生率均低于对照组,差异有统计学意义。结论：氟化泡沫能有效预防学龄前儿童龋病发展。     

A review of systemic and topical fluorides for the prevention of dental caries

ABSTRACT Because community fluoridation constitutes nearly an ideal public health method, it should be the cornerstone of all national programs of dental caries prevention. Where fluoridation is not possible for technical or political reasons, some alternative methods of providing benefits from systemic fluorides are available, including school water fluoridation, dietary supplements of fluoride and the fluoridation of salt. Dietary supplements of fluoride are not recommended for pregnant women for caries protection in their offspring. In areas with low fluoride levels in drinking water, solutions of 2 % sodium fluoride, 8% stannous fluoride and acidulated phosphate-fluoride (APF) (1.2% F ion) and the same concentration of an APF gel applied professionally can prevent dental caries. APF is currently the choice for these applications. Fluoride prophylaxis pastes should be used, particularly when a topical fluoride application is not scheduled to follow the prophylaxis. Effective unsupervised topical fluoride applications occur with use of fluoride containing dentifrices. Supervised self-applications of fluoride for public health programs overcome the inefficiencies of individual professional applications. Many studies continue to be reported on mouth-rinsing with fluoride solutions, toothbrushing with fluoride solutions and gels, toothbrushing with fluoride prophylaxis pastes and the application of fluoride gels in mouthpieces. Fluoride mouth-rinsing has several advantages. Self-application of fluorides will undoubtedly become the method of choice for delivering topical fluorides.     

The use of fluoride varnishes in the prevention of dental caries: a short review

OBJECTIVES: To review the current literature regarding the anti-caries efficacy of fluoride varnishes. To analyse a series of studies designed to detect the caries preventive efficacy of fluoride varnishes by means of meta-analysis. MATERIALS AND METHODS: Current literature on fluoride varnishes has been reviewed. An evaluation of the results of the available in vitro, animal and human studies on the anti-caries efficacy of these preventive agents was performed. A systematic literature search and a meta-analysis were also performed to assess the caries preventive effects of fluoride varnishes. The purpose of this analysis was to calculate the overall preventive efficacy of clinical fluoride varnishes treatment studies, based on defined methodological criteria. RESULTS: The efficacy of fluoride varnishes in caries prevention is clearly demonstrated in several experimental studies. Clinical trials show caries incidence reduction ranging approximately from 18% to 70%. Nevertheless, available studies show a high degree of heterogeneity and only three were found to meet a series of defined methodological criteria. All the three studies were based on a comparison between 0.2% NaF rinses and a fluoride varnish. The meta-analysis showed no significant differences between the two treatments. CONCLUSIONS: Available data suggest that fluoride varnishes are a useful tool in caries prevention. One may conclude that fluoride varnishes, when applied regularly, demonstrate good caries preventive properties.     

The place of fluoride supplements in caries prevention today

A bstract — There are very few scientifically good clinical trials of fluoride supplements, and those that can be considered methodologically adequate suggest that the contribution of fluoride supplements to caries prevention is slight. This may be partly a consequence of the fact that fluoride is much more widely available today than was the case a generation ago when fluoride toothpaste was not widely used and water fluoridation was not fully implemented. Although some families are conscientious in their use, compliance with fluoride supplement recommendations is generally poor over longer periods, making them a poor public health measure. There is substantial evidence that supplements cause dental fluorosis when used in accordance with recommendations for infants and small children. If the public becomes concerned about dental fluorosis as an aesthetic problem, all fluoride use may be put at risk. Supplements should no longer be recommended for caries prevention in children in areas with little fluoride in water but may be useful for persons with intractable caries risks. If supplements are recommended for children, a more cautious dosage schedule should be used. The fact that supplements have been recommended uncritically for many years on the basis of inadequate research raises questions about the standards of dental science.     

Allocation of dental caries prevention in Swedish teenagers

Abstract – In this study, the hypothesis that teenagers with high caries activity on proximal surfaces receive more preventive care in the Swedish Public Denial Health Service than those with lower caries activity on these surfaces, was tested in an audit study. Dental records and bitewing radiographs from 1987 and 1991 were used to assess caries progression in 406 teenagers from the age of 13 to the age of 17. The time allocated to prevention during the period was also registered. Caries progression as a measure of disease activity was tested. The results showed that the hypothesis could not be verified. The Odds ratio was 1.35. indicating that the chance to gel more than 15 min preventive time during 4 yr was only 1.35 times higher if you were highly caries active than if you were less caries active. Although the reproducibility of the method to use caries progression as a measure of disease activity was not high, it was considered a better indicator of active disease than the number of DMF surfaces.     

Three-year report on caries prevention using fluoride varnishes for caries risk children in a community with fluoridated water

Abstract – The Benifit of seminnual application of the sodium fluoride varnish Duraphat^(R) and the silane fluoride varnish Fluor Protector^(R) was studied in 11–13-year-old children with high caries activity and lifelong exposure to fluoridated drinking water (1–1.2 parts/10⁶). Annual clinical and radiographic examinations were made of 62 children in the Duraphat group and 70 children in the Fluor Protector group. Fluoride varnish was applied semiannually using the half-moth technique. After 3 years, for the Duraphat group mean total DMES increments on the control side were 6.2 and on the test side 4.3 ( P <0.001); for the Fluor Protector group the DMES increments were 4.9 and 4.4, respectively (NS). The caries reductions were 30% and 11%. Since ther were no differences between initial mean DMES scores of the groups, it is possible that the lower increment in the Fluor Protector control side compatred to the Duraphat control side was due to fluoride ions from Fluor Protector crossing the midline and providing protection on the control side as well. Therefore, we conclude that Duraphat proved effective, but definite conslusion of the effect of Fluor Protector cannot be made. Children with the highest DMES increment on the control side (duraphat) gained most from the applications.     

Chlorhexidine varnish for preventing dental caries in children, adolescents and young adults: a systematic review

This systematic review aimed to determine the caries-inhibiting effect of chlorhexidine (CHX) varnishes on the permanent dentition of children, adolescents and young adults, and to explore two possibly related factors, namely application frequency and the time between evaluation and the last application. The literature search identified 14 publications of randomized controlled trials or controlled clinical trials where the effect of CHX varnish was compared with placebo controls or controls that received no preventive treatment. To obtain uniform outcome effects, the prevented fraction and 95% confidence intervals of caries increment were calculated. Owing to insufficient data presentation, only eight publications were included. Another two publications were included after receiving additional data from the authors. This systematic review did not result in a meta-analysis as an overall prevented fraction could not be computed because of the large variation of outcome results. The variation could not be explained by the time between evaluation and last application but might be explained by application frequency. It is tentatively concluded that CHX varnish has a moderate caries-inhibiting effect when applied every 3-4 months. However, this effect seems to have diminished by around 2 yr after the last application. There is no evidence for a caries-inhibiting effect of CHX varnish with longer intervals between applications.