An Examination of the Advances in Science and Technology of Prevention of Tooth Decay in Young Children Since the Surgeon General's Report on Oral Health
An Examination of the Advances in Science and Technology of Prevention of Tooth Decay in Young Children Since the Surgeon General's Report on Oral Health
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DOI：
10.1016/j.acap.2009.09.001
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发表时间：
2009-11-01
影响因子：
3.1
通讯作者：
Tanzer, Jason M.
中科院分区：
文献类型：
--
作者：
Milgrom, Peter;Zero, Domenick T.;Tanzer, Jason M.
本文讨论了与科学技术如何有效实现“2010 年健康人”预防蛀牙目标相关的多个领域。在提到的每个领域，科学和技术似乎都未能实现这些目标。早期的评估认为水氟化是上世纪最伟大的公共卫生成就之一。然而，未能完成所需的临床和转化研究在关键时刻改变了龋齿预防议程。科学已经牢固地确立了蛀牙的传染性。然而，有证据表明，尽管其他年龄组也取得了进展，但幼儿蛀牙现象仍在增加。风险评估研究尚未转化为改进的实践。防腐剂、氯己定清漆和聚乙烯吡咯烷酮碘 (PVI-I) 可能有价值，但需要进行明确的试验。氟化物仍然是最有效的药物，但没有广泛传播给最需要的人。氟化物清漆为幼儿提供了相对有效的局部预防措施，但尚未进行明确的试验。二胺氟化银也有潜力，但需要在美国进行研究。数据支持木糖醇的有效性和安全性，但采用并不广泛。牙科密封剂仍然是公共政策的支柱，但经过数十年的研究，尚未广泛使用。我们的结论是，研究已经确定了蛀牙对公众健康的负担，但没有足够的研究解决《美国口腔健康：外科医生报告》报告中指出的问题。为了预防儿童蛀牙，需要将技术从研究转移到实施。这应该涉及转化研究以及将科技进步付诸实践。
This paper addresses a number of areas related to how effectively science and technology have met Healthy People 2010 goals for tooth decay prevention. In every area mentioned, it appears that science and technology are falling short of these goals. Earlier assessments identified water fluoridation as one of the greatest public health accomplishments of the last century. Yet, failure to complete needed clinical and translational research has short-changed the caries prevention agenda at a critical juncture.Science has firmly established the transmissible nature of tooth decay. However, there is evidence that tooth decay in young children is increasing, although progress has been made in other age groups. Studies of risk assessment have not been translated into improved practice. Antiseptics, chlorhexidine varnish, and poly-vinylpyrrolidone iodine (PVI-I) may have value, but definitive trials are needed. Fluorides remain the most effective agents, but are not widely disseminated to the most needy. Fluoride varnish provides a relatively effective topical preventive for very young children, yet definitive trials have not been conducted. Silver diamine fluoride also has potential but requires study in the United States. Data support effectiveness and safety of xylitol, but adoption is not widespread. Dental sealants remain a mainstay of public policy, yet after decades of research, widespread use has not occurred.We conclude that research has established the public health burden of tooth decay, but insufficient research addresses the problems identified in the report Oral Health in America: A Report of the Surgeon General. Transfer of technology from studies to implementation is needed to prevent tooth decay among children. This should involve translational research and implementation of scientific and technological advances into practice.