目的 评估对学龄儿童第一恒磨牙进行局部涂氟的防龋效果, 为制定学龄儿童龋病防治策略提供依据.方法 选取2014年11月广西大化县某小学一年级6～7岁儿童666例, 采用整群随机抽样的方法, 分为试验组与对照组.从2014年11月到2017年5月, 试验组儿童每半年进行1次第一恒磨牙局部涂氟, 同时进行口腔健康教育;对照组儿童仅进行口腔健康教育, 并在2014、2016、2017年的11月对所有研究对象进行口腔检查, 收集第一恒磨牙患龋情况数据并进行统计分析.结果干预2年后, 试验组第一恒磨牙龋病发病率低于对照组, 差异有统计学意义 (P<0.05) ;干预3年后, 试验组患龋率、龋均、龋面均及龋病发病率均低于对照组, 差异具有统计学意义 (P<0.05) .干预后, 试验组上下颌第一恒磨牙龋病发病率及窝沟龋发病率均低于对照组, 差异有统计学意义 (P<0.05) , 邻面龋发病率差异无统计学意义 (P>0.05) .结论 局部涂氟对第一恒磨牙龋具有良好的预防效果, 且涂氟时间越长, 防龋效果越好.%Objective To assess the effect of topical fluoride varnish on the prevention of the first permanent molar caries of schoolage children and provide evidence for formulating caries prevention strategies. Methods Using cluster random sampling method, in November 2014, 666 children of 6-7 years old in the first grade of primary school in Dahua County, Guangxi province were randomly selected and divided into two groups: the test group and the control group. From November 2014 to May 2017, the children in the test group were treated with fluoride varnish every six months, along with oral health education; whereas, children in the control group were only given oral health education. In November of 2014, 2016, and 2017, oral examinations were performed on all subjects to collect data of the first permanent molars and conduct statistical analysis. Results After 2 years of intervention, the incidence of dental caries in the first permanent molar in the test group was lower than that in the control group, and the difference was statistically significant ( P<0.05). After 3 years of intervention, the prevalence and incidence of caries, mean DMFT and mean DMFS in the test group were all lower than those in the control group, and there was a significant difference ( P<0.05). After intervention, the incidences of maxillary and mandibular first molar, fissure and proximal surface caries of the first permanent molars in the test group were lower than those of control group, but there was no significant difference in the incidence of proximal surface caries ( P>0.05). Conclusion The topical application of fluoride varnish is effective in prevention of caries of the first permanent molars, and the longer the exposure time of fluoride varnish is, the better the effect of prevention is.
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