Finding #1 – The Effectiveness of Drinking Water Fluoridation in Preventing Caries Historical Perspective
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چکیده
In 1901, a Colorado Springs dentist recognized that his patients with teeth with a brown stain or mottled dental enamel also had a very low prevalence of cavities (also called caries) (Centers for Disease Control and Prevention [CDC], 1999b). At this time in history, extensive dental caries were common, so this observation and its subsequent correlation with high amounts of fluoride ion in the water supply (2.0 12.0 milligrams per liter, mg/L) proved to be significant. Another dentist, H.T. Dean, DDS., took this information and conducted a survey of dental caries in relation to natural concentrations of fluoride in drinking water of 21 U.S. cities (Committee to Coordinate Environmental Health and Related Programs, USPHS [USPHS], 1991 pp.18-19; CDC, 1999a, p. 934). Dean observed that at a concentration of 1 mg/L, fluoride would significantly reduce caries while causing a low incidence of mottled enamel, now called fluorosis, of the mostly very mild type. Beginning in 1945 and 1946, community trials were conducted over 13-15 years in four pairs of cities in the U.S. and Canada. These studies found a 50-70% reduction of caries in children following addition of fluoride (in the form of sodium fluoride) to community water supplies at 1 mg/L. The incidence of mild fluorosis remained low (CDC, 1999a, p. 936). Some of the early studies were criticized for lacking appropriate controls, not applying randomization, and not controlling for potential examiner bias (Sutton, 1960). However, the large effect sizes in these trials, along with replication of these findings in subsequent studies, led to the acceptance of community water fluoridation as a public health approach to caries prevention.
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تاریخ انتشار 2005