饮水氟对儿童龋齿的影响
Effect of fluoride in drinking water on children's dental caries
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摘要:目的 探讨饮水氟含量与儿童龋齿患病率之间的相关关系和预防龋齿的适宜饮水氟浓度。方法 采用流行病学方法调查江苏省某县新淮村〔饮水氟含量范围和均值分别为0.18~0.76和(0.36±0.11)mg/L, 8~13岁小学生290名〕和瓦庙村〔饮水氟含量范围和均值分别为0.57~4.50和(2.46±0.80)mg/L, 8~13岁小学生222名〕儿童龋齿患病率, 并按照饮水氟含量不同将儿童分为不同接触组, 即 < 0.5, 0.5, 10, 15, 2.0, 2.5, 30, 35和≥4.0mg/L等9个组, 探讨饮水氟含量与儿童龋齿患病率之间的剂量-效应关系, 并计算饮水氟含量的基准剂量95%可信限下限(BMDL)。结果 低浓度时(饮水氟含量 < 2.72mg/L)随着饮水氟含量的增加, 儿童龋齿患病率逐渐降低; 当饮水氟含量 > 2.72mg/L时, 随着饮水氟含量的增加, 儿童龋齿患病率逐渐升高。饮水氟含量和儿童龋齿患病率之间的剂量-效应关系为U型曲线。根据这一剂量-效应关系, 分别计算低浓度和高浓度时饮水氟含量的BMDL为3.09和2.59mg/L。考虑到龋齿致病原因和摄氟途径的复杂性, 计算所得的参考剂量(RfD)值为155和129mg/L。结论 根据WHO的推荐值及国内外的研究结论, 结合本次调查结果, 可以认为在研究地区预防龋齿最佳的饮水氟浓度为1.0~1.5 mg/L。Abstract:Objective To study the relationship between the fluoride in drinking water and the prevalence of children's dental caries, and try to find the suitable concentration of fluoride in drinking water for dental caries prevention.Methods Epidemiologic methods were used to investigate the prevalence of children's dental caries in Xinhua (drinking water fluoride mean and range in mg/L: 0.36±0.11, 0.19-0.76, children aged 8-13 years old, 290) and Wamiao (2.46±0.80, 0.574.50, 222 children aged 8-14 years old). Children were divided into nine subgrouups according to the drinking water fluoride: < 0.5, 0.5-, 1.0-, 1.5-, 2.0-, 2.5-, 3.0-, 3.5 and≥4.0 mg/L. To explore the dose-response relationship between the drinking water fluoride and the prevalence of children's dental caries, and calculate the BMDL(the LowerBound Confidence Limit on BenchMark Dose).Results As the fluoide in drinking water increased the prevalence of children's dental caries reduced gradually when the fluoride in drinking water below 2.72 mg/L, but there were positive relationship when drinking water fluoride over 2.72 mg/L. The dose-response relationship between the fluoride in drinking water and the prevalence of children's dental caries was a U-shape. Considering the complicated cause of dental caries and other sources of dietary fluoride, the RfD (reference value dose) were calculated to be 1.55 mg/L and 1.29 mg/L.Conclusion The suitable concentration of fluoride in drinking water for prevention dental caries was 1.0-1.5 mg/L in the investigated area.
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