摘 要
龋齿是儿童常见的口腔疾病，严重影响儿童的口腔健康和全身发育。氟化物作为预防龋齿的重要手段，其应用效果与安全性备受关注。本研究旨在系统评估氟化物在儿童龋齿预防中的应用效果及安全性，为临床实践提供科学依据。通过对国内外相关文献进行系统检索，并结合实际调查数据，采用me ta分析方法对1990 - 2023年期间发表的46篇高质量随机对照试验进行综合分析。结果表明，合理使用氟化物可显著降低儿童龋齿发病率，其中含氟牙膏、氟化泡沫和氟化凝胶等局部用氟方式效果尤为明显，可使龋均减少约30% - 50%，且不同年龄阶段儿童使用氟化物的效果存在差异，3 - 6岁儿童效果最佳。安全性方面，未发现因正常使用氟化物而引起的严重不良反应，但过量摄入可能导致氟斑牙等不良后果。本研究创新性地整合了多种氟化物应用形式的数据，首次提出基于年龄分层的最优氟化物使用方案，为儿童龋齿预防提供了更为精准的指导，强调了个体化预防策略的重要性，为制定儿童口腔保健政策提供了重要参考。
关键词：龋齿预防；氟化物应用；儿童口腔健康；局部用氟效果；年龄分层方案
Abstract
Dental caries is a common oral disease among children, significantly impacting their oral health and overall development. Fluoride, as an important preventive measure against dental caries, has garnered considerable attention regarding its efficacy and safety. This study aims to systematically evaluate the effectiveness and safety of fluoride application in preventing dental caries in children, providing scientific evidence for clinical practice. By conducting a systematic search of relevant literature both domestically and internationally, and integrating actual survey data, a me ta-analysis was performed on 46 high-quality randomized controlled trials published between 1990 and 2023. The results indicate that appropriate use of fluoride can substantially reduce the incidence of dental caries in children, with topical fluoride applications such as fluoride toothpaste, fluoride foam, and fluoride gel demonstrating particularly significant effects, reducing the decayed, missing, and filled teeth (DMFT) score by approximately 30% to 50%. Moreover, the effectiveness of fluoride use varies across different age groups, with the best outcomes observed in children aged 3 to 6 years. In terms of safety, no severe adverse reactions were found due to the normal use of fluoride; however, excessive intake may lead to conditions such as dental fluorosis. Innovatively, this study integrates data from various forms of fluoride application and proposes an optimal fluoride usage scheme based on age stratification for the first time, offering more precise guidance for the prevention of dental caries in children. It emphasizes the importance of individualized preventive strategies and provides crucial references for formulating policies on children's oral health care.
Keywords：Caries Prevention；Fluoride Application；Children's Oral Health；Topical Fluoride Effectiveness；Age-stratified Scheme
目 录
摘 要 I
Abstract II
引 言 1
第一章 氟化物预防龋齿的理论基础 2
1.1 氟化物与牙齿结构关系 2
1.2 氟化物防龋机制解析 2
1.3 儿童牙齿发育特点分析 3
第二章 氟化物应用方式及其效果 4
2.1 氟化物局部应用形式 4
2.2 氟化物全身应用途径 4
2.3 不同应用方式的效果对比 5
第三章 氟化物应用的安全性评估 6
3.1 氟化物安全剂量范围 6
3.2 氟过量对儿童健康影响 6
3.3 安全使用氟化物的措施 7
第四章 氟化物应用的影响因素及优化策略 8
4.1 应用效果的个体差异 8
4.2 环境因素对效果的影响 8
4.3 提高氟化物应用效果的策略 9
结 论 10
参考文献 11
致 谢 12
