Aim: The aim of our study was to chronologically analyse various public health measures of fluoride use in caries prevention.
Methods: We systematically searched the PubMed database on the preventive role of fluorides in public health, published from 1984 to 2014. The search process was divided into four steps, where inclusion and exclusion criteria were defined. Qualitative methodology was used for the article analysis. In the research process, the described forms of F use, diversity of the described F agents, and the observed population group were analysed.
Results: In our systematic review, 40 relevant reviews were revealed. Fluorides have been used in many different forms, but only a few studies showed their significant role in public health. Water fluoridation was the most important public health measure. In the recent decades, the number of studies on topical fluorides is constantly rising. The most extensively described topical forms of fluorides are professionally applied fluoride agents and fluoride toothpaste for home-use. The use of fluoride containing toothpaste in caries prevention is a safe and successful public health measure (PHM) if their use is widespread, and it is recommended for all. The results on other topical forms of fluorides are insufficient to be suggested as an important PHM.
Conclusions: The role of fluorides in public health prevention has changed in accordance with the knowledge about the fluoride cariostatic mechanism. Previously the most important pre-eruptive effect of fluorides was supplemented by the post eruptive effect. Abundant evidence exists to show the effectiveness of systemic and topical fluorides.
Namen: Namen naše raziskave je bil kronološko analizirati različne načine javnozdravstvene uporabe fluoridov pri preventivi kariesa.
Metode: Sistematično smo pregledali pregledne članke v bibliografski bazi PubMed, ki so bili objavljeni v obdobju od leta 1984 do leta 2014. Iskalni proces je potekal v štirih fazah, v katerih smo določili vključitvene in izključitvene kriterije za določitev člankovza končno analizo. Za analizo člankovsmo uporabili kvalitativno metodologijo. V procesu analiziranja smo se osredotočili na razlicne oblike in načine uporabe fluoridov, jih opisali ter opredelili uporabo fluoridov in pomen za populacijo, v kateri so bili uporabljeni.
Rezultati: V našem sistematičnem pregledu smo analizirali 40 preglednih člankov. Opisane so številne oblike uporabe fluoridov, vendar le nekatere raziskave poudarjajo javnozdravstveni pomen. Fluoridiranje pitne vode je najpomembnejši javnozdravstveni ukrep. Povecalo se je število raziskav, ki proučujejo topikalne fluoride. Največ raziskav opisuje profesionalne pripravke s fluoridi in kreme za zobe s fluoridi za domačo uporabo. Uporaba kreme za zobe s fluoridi je varen in uspešen javnozdravstveni ukrep v preventivi kariesa, zato ga priporočamo za celotno populacijo. Rezultati o drugih oblikah topikalnih fluoridov so nezadostni, zato jih ni mogoče označiti kot pomembne javnozdravstvene ukrepe.
Zaključki: Vloga fluoridov se je spremenila v skladu z znanjem o njihovem delovanju. V preteklosti najpomembnejšemu preeruptivnemu delovanju se je pridružilo razumevanje o posteruptivnem učinku fluoridov. Obstajajo jasni dokazi o učinkovitosti tako sistemskih kot topikalnih fluoridov.
Keywords: caries prevention; epidemiology; fluorides; public health dentistry.