■虽然氟化物对健康的影响已被广泛研究,研究水中氟化物水平与氟斑牙之间关系的高质量研究较少。
■研究饮用水中氟化物暴露与氟斑牙之间的关系。
■这项横断面研究使用了2013-2014年和2015-2016年国家健康与营养检查调查(NHANES)数据(2013年1月1日,至2016年12月31日)。NHANES使用复杂的抽样技术来开发具有全国代表性的美国人口样本估计,包括访谈和身体评估。包括6至15岁的儿童和青少年,因为NHANES包含所有三种形式的氟化物测量数据:血浆氟化物水平,氟化物的水含量,和膳食氟补充剂。对2023年1月1日至4月30日的数据进行了分析。
■由实验室人员测量水和血浆氟化物水平。膳食氟化物补充数据是自我报告的。
■使用Dean的氟中毒指数评估每颗牙齿的氟中毒状况。氟斑牙严重程度值基于第二大受影响的牙齿。独立变量包括血浆和水氟化物浓度以及膳食氟化物补充。使用独立样本t检验比较各组之间的氟化物暴露。和Pearson相关性评估血浆和水氟化物水平之间的关联。为了评估氟化物暴露是否与氟斑牙相关,进行logistic回归分析.
■在2013-2014年NHANES周期中有1543名参与者(加权比例男性,51.9%;平均[SD]年龄,11.0[2.7]年)和2015-2016年周期中的1452年(加权比例男性,52.6%;平均[SD]年龄,11.1[2.8]年)。加权的87.3%在2013-2014年周期中表现出一定程度的氟中毒,在2015-2016年周期中表现出68.2%。水和血浆中氟化物含量较高与氟斑牙几率较高显著相关(调整后的比值比,2013-2014年周期为2.378[95%CI,2.372-2.383],2015-2016年周期为1.568[95%CI,1.564-1.571])。
■这项横断面研究的结果表明,暴露于水中较高浓度的氟化物和血浆中的氟化物水平较高与氟斑牙的风险更大。进一步的研究可以帮助政策制定者制定政策,以平衡实质性龋齿预防与氟斑牙的风险。
While the effects of fluoride on health have been widely researched, fewer high-quality studies examine the association of fluoride levels in water and dental fluorosis.
To investigate the association between fluoride exposure from drinking water and dental fluorosis.
This cross-sectional
study used the 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey (NHANES) data (January 1, 2013, through December 31, 2016). NHANES uses a complex sampling technique to develop nationally representative sample estimates of the US population that consists of interviews and physical assessments. Children and adolescents aged 6 to 15 years were included because NHANES contains their data for all 3 forms of fluoride measures: plasma fluoride levels, water levels of fluoride, and dietary fluoride supplementation. Data were analyzed from January 1 to April 30, 2023.
Water and plasma fluoride levels were measured by laboratory personnel. Dietary fluoride supplement data were self-reported.
The Dean\'s Fluorosis Index was used to evaluate fluorosis status for each tooth. The dental fluorosis severity value was based on the second most affected tooth. Independent variables included plasma and water fluoride concentrations and dietary fluoride supplementation. An independent samples t test was used to compare fluoride exposures between groups, and Pearson correlation assessed the association between plasma and water fluoride levels. To assess whether fluoride exposures were associated with dental fluorosis, logistic regression analyses were conducted.
There were 1543 participants in the 2013-2014 NHANES cycle (weighted proportion male, 51.9%; mean [SD] age, 11.0 [2.7] years) and 1452 in the 2015-2016 cycle (weighted proportion male, 52.6%; mean [SD] age, 11.1 [2.8] years). A weighted 87.3% exhibited some degree of fluorosis in the 2013-2014 cycle and 68.2% in the 2015-2016 cycle. Higher fluoride levels in water and plasma were significantly associated with higher odds of dental fluorosis (adjusted odds ratios, 2.378 [95% CI, 2.372-2.383] in the 2013-2014 cycle and 1.568 [95% CI, 1.564-1.571] in the 2015-2016 cycle).
The findings of this cross-sectional
study suggest that exposure to higher concentrations of fluoride in water and having higher plasma levels of fluoride were associated with a greater risk of dental fluorosis. Further research can help policy makers develop policies that balance substantial caries prevention with the risk of dental fluorosis.