自从Dean的经典流行病学研究以来,众所周知,应该有一个最佳的氟化物暴露水平,能够提供最大的龋齿保护,氟斑牙最少。根据经验确定了全球仍被接受的儿童每日最佳氟化物摄入量(每公斤体重0.05-0.07mg)。在本次审查中,我们讨论了目前氟化物摄入量指南的适当性,鉴于龋齿和氟中毒的易感性,从多种来源摄入氟化物的现代趋势,氟化物代谢的个体差异,和最近的流行病学数据。主要结论是,根据1)氟化物控制龋齿的作用机制的现有知识,很难考虑在个体水平上对氟化物摄入量的“最佳”范围的严格建议,2)氟斑牙发展的机制,3)干扰氟化物代谢的独特因素,4)龋齿和氟中毒发展的敏感性窗口。氟化物摄入量的“最佳”范围是,然而,在人口层面上,有必要指导社区氟化计划,但进一步的研究是必要的,以提供额外的支持,在这一领域的指导未来的决策。此列表包括影响氟化物代谢的因素的影响,关于低氟牙膏预防原发性牙列龋齿的有效性的临床试验,和验证暴露于氟化物的生物标志物。
Since the classical epidemiological studies by Dean, it has been known that there should be an optimum level of exposure to fluoride that would be able to provide the maximum protection against caries, with minimum dental fluorosis. The \"optimal\" daily intake of fluoride for children (0.05-0.07 mg per kilogram bodyweight) that is still accepted worldwide was empirically determined. In the present review, we discuss the appropriateness of the current guidance for fluoride intake, in light of the windows of susceptibility to caries and fluorosis, the modern trends of fluoride intake from multiple sources, individual variations in fluoride metabolism, and recent epidemiological data. The main conclusion is that it is very difficult to think about a strict recommendation for an \"optimal\" range of fluoride intake at the individual level in light of existing knowledge of 1) the mechanisms of action of fluoride to control caries, 2) the mechanisms involved in dental fluorosis development, 3) the distinct factors that interfere in the metabolism of fluoride, and 4) the windows of susceptibility to both dental caries and fluorosis development. An \"optimal\" range of fluoride intake is, however, desirable at the population level to guide programs of community fluoridation, but further research is necessary to provide additional support for future decisions on guidance in this area. This list includes the effect of factors affecting fluoride metabolism, clinical trials on the effectiveness of low-fluoride dentifrices to prevent caries in the primary dentition, and validation of biomarkers of exposure to fluoride.