He aha te take e tino aro nui ai te USA ki te fluoride i roto i te parai niho

Te Papamuri o te Pūhaumāota i roto i te Hauora Waha o te US

Ko te whakamahinga o te fluoride i roto i ngā mahi niho o Amerika i ahu mai i te tīmatanga o te rautau 20, i te wā i kitea ai e Tākuta Frederick McKay te "Colorado Brown Stain," i muri mai ka honoa ki te nui rawa o te fluoride tūturu i roto i te wai. I te tau 1945, ko Grand Rapids, Michigan te tāone tuatahi o te ao i tāpirihia he fluoride ki tana puna wai tūmatanui, e whakaatu ana i ngā taunakitanga mārama ka whakaitihia e te fluoride ngā poka niho. I te tekau tau atu i 1970, neke atu i te 100 miriona o ngā Amerikana i whiwhi wai whai fluoride, ā, ka huri tere ngā rangahau ki te whakauru i te fluoride ki roto i te paraihe niho.

I te tau 1956, i whakaurua mai e Procter & Gamble a Crest, te paraihe niho whaiwhaiwhai tuatahi i hokohokohia ā-motu. I whiwhi a Crest i te Tohu Whakaaetanga a te American Dental Association i te tau 1960, ā, i akiaki i ētahi atu waitohu ki te whai i taua tohu. I te tekau tau atu i 1970, kua tino whakapumautia te whaiwhaiwhai hei matū paerewa mō te whawhai i ngā poka, ā, tata ki ngā paraihe niho rongonui katoa i runga i ngā whata o Amerika he whaiwhaiwhai kei roto.

Te Tono me te Ture

Te Whakamahinga o te Parai Niho Fluoride i te Mākete o Amerika

Whai muri i te whakarewatanga angitu o Crest, i tere te panonitanga o te mākete paraihe niho o Amerika. I te tekau tau atu i 1980, tata ki ngā waitohu nui katoa i tuku i te hanganga fluoride, ā, i piki ake te whakamahinga a ngā kaihoko. I whakaatuhia e ngā rangahau mākete i te tekau tau atu i 1990 neke atu i te 90% o ngā tamariki me ngā pakeke o Amerika i paraihe ki te paraihe niho fluoride. I ēnei rā, ko ngā hua kei roto i te fluoride te nuinga o ngā wāhi hokomaha, nā ngā taunakitanga kaha mai i ngā tākuta niho me te whakaritenga me whai fluoride tetahi paraihe niho kei roto te hiri ADA.

Anga Whakahaere e Whakahaere ana i te Hauhā i roto i te Paraihe Niho

I te Hononga o Amerika, kua whakahaeretia te paraihe niho fluoride hei rongoā hoko kore-tohu (OTC) i raro i te Anticaries Monograph (21 CFR 355) a te Food and Drug Administration (FDA). E whakaaetia ana e te FDA ngā matū fluoride motuhake—pērā i te konutai fluoride, te konutai monofluorophosphate, me te stannous fluoride—i ngā kukū kua whakaritea. Ko ngā hanganga paraihe niho paerewa e herea ana ki te 850–1,150 ppm fluoride (0.085%–0.115% fluoride ion). Ka whakaaetia te kāwai "he nui te fluoride" (tae atu ki te 1,500 ppm) me ngā whakatūpato haumaru tāpiri; mēnā he nui ake i te 1,500 ppm me tono rongoā.

He tino pakari hoki ngā whakaritenga tapanga. Me mārama te tohu o te parai niho he "anticavity" he "fluoride" rānei i roto i te ingoa o te hua, me whakarārangi te whakauru fluoride hohe me tōna ōrau, ā, me whakaatu he whakatūpato haumaru mō ngā tamariki i raro i te "Drug Facts": "Puritia kia kore e taea e ngā tamariki kei raro iho i te 6 tau te pakeke te toro atu. Mena ka horomia he nui atu i te mea e whakamahia ana mō te paraihe, rapua he awhina hauora, whakapā atu rānei ki te Poison Control Center tonu." Me whakahau hoki ngā tohutohu whakamahi—pēnei i te paraihe i ngā wā e rua i te rā me te tirotiro i ngā tamariki kei raro iho i te 6 tau te pakeke. Mā ēnei ture ka whiwhi ngā kaihoko i ngā aratohu mārama mō te whakamahinga haumaru me te whai hua o te fluoride.

Te whai huatanga me te haumaru

Ngā Painga me te Whai Huatanga o te Hauora Tūmatanui

E whakaatu ana ngā tekau tau o ngā rangahau he nui te whakaiti a te paraihe niho whai fluoride i te pirau o ngā niho. I kitea i roto i tētahi arotake nui mai i te Cochrane Collaboration, he pai ake te ārai a te paraihe niho whai fluoride (≥1,000 ppm) i ngā poka niho i roto i ngā tamariki i ngā momo rongoā kāore he fluoride. I te toharite, ko te paraihe niho e rua i te rā ki te paraihe niho whai fluoride ka whakaiti i te mōrearea o te pirau niho mā te 14–30%. Mā te mahi ā-kiri o te fluoride ka āwhina i te whakaora i te enamel, ā, ina honoa ki te wai whai fluoride, ka taea te whakaiti i te pirau tae atu ki te 25% i te taumata taupori. Kua whakaatahia ēnei hua i roto i ngā whenua o te ao, e whakaū ana i te paraihe niho whai fluoride hei tētahi o ngā wawaotanga hauora tūmatanui tino whai hua mō te hauora waha.

Ngā Āwangawanga Haumaru me ngā Tautohenga

Ko te āwangawanga matua mō te haumaru o te paraihe niho fluoride ko te nui rawa o te pānga ki ngā tamariki nohinohi, ka arahi pea tēnei ki te fluorosis niho (he mā, he parauri rānei ngā niho). E whakaatu ana ngā raraunga o Amerika mai i te tau 1999–2004 e 40% pea o ngā taiohi e whakaatu ana i tētahi taumata o te fluorosis, ahakoa he ngawari noa iho te nuinga o ngā take, ā, he āhua ataahua noa iho. Hei whakaiti i te mōrearea, ka tūtohu ngā tohunga hauora kia whakamahia he nui o te paraihe niho "he rite ki te witi raihi" mō ngā tamariki kei raro iho i te 3 tau te pakeke, me te nui "he rite ki te rahi pī" mō ngā tau 3–6, me te tirotiro a te pakeke kia kore ai e horomia.

He tino onge te paihana whakapeka o te fluoride mai i te paraihe niho, me te nui o te horomitanga. E whakaū ana ngā whakahaere hauora matua—tae atu ki te CDC, ADA, me te American Academy of Pediatrics—he haumaru te paraihe niho fluoride ina whakamahia kia rite ki ngā tohutohu. Ahakoa he iti noa ngā rangahau kua whakaara ake i ngā pātai mō te pānga o te fluoride ki te whanaketanga o te roro i ngā taumata teitei o te pānga, he nui ake ēnei pānga i te mea ka whiwhi te tamaiti mai i te paraihe niho, i te wai rānei kua whai fluoride.

I roto i te poto

Ki te whai ngā mātua i ngā tohutohu whakamahinga kua tohua, he iti noa te mōrearea o ngā kino ā-tinana.

Ngā Mahi Tōrangapū me ngā Mahi Ture i te US i ēnei rā tata nei

I te tau 2024 me te tau 2025, i neke ētahi kawanatanga ki te aukati i te whakawhaiaro i te wai hapori—he mahi e pā kino ana ki te whakawhirinaki o te marea ki te paraihe niho whaiwhaiaro. Hei tauira, i paahitia e Utah me Florida he ture e aukati ana i te whakawhaiaro i te wai, ā, i puta ai he whakahē nui mai i ngā tohunga niho me te hauora tūmatanui e whakatūpato ana ko te tango i te whaiwhaiaro ka nui ake te poka, inā koa i waenga i ngā tamariki. I whakahaua hoki e te kaiwhakawā ā-motu te EPA kia arotakehia anō ngā paerewa whaiwhaiaro wai inu, me te whakahua i ngā rangahau mō ngā pānga whanaketanga roro pea. Ahakoa kei raro i te piira tēnei whakataunga, i whakaū anō te CDC me te ADA ko te whakawhaiaro tonu tetahi o ngā whakatutukitanga hauora tūmatanui nui rawa atu i roto i te hītori o Amerika.

Kua kaha ake hoki te tirotiro ture mō te hokohoko paraihe niho. I te tīmatanga o te tau 2025, i tukuna ngā kereme whakawakanga ā-rōpū ki ngā kaihanga paraihe niho nui, e kī ana he hokohoko "tinihanga" ki ngā tamariki—e kī ana ko ngā paraihe niho reka, he waitohu pakiwaituhi e akiaki ana i te horomitanga me te whakapohehe i ngā mātua. I tīmatahia e te Roia Matua o Texas tētahi rangahau mō te takahi a te takai me te pānuitanga i ngā aratohu a te FDA mō te whakamahinga o te fluoride. I whakautu te ADA mā te kī anō he haumaru, he whai hua hoki te paraihe niho fluorescent, e whakamahia ana i raro i te tirotiro.

Te Urupare a te Ahumahi me ngā Mahi Pai rawa atu

Ko ngā kaihanga nui o ngā paraihe niho—pērā i a Colgate-Palmolive me Procter & Gamble—e aro nui ana ki te piripono ki ngā whakaritenga a te FDA, te whakamātautau pakari i ngā kai, me te tapanga mārama. E whakaatu mārama ana rātou i te hiri whakaae a te ADA ki runga i ngā takai hei whakamana i ngā kaihoko ki te whakamana a te hunga tuatoru. Kei roto hoki i ngā kaihanga ngā taupoki ātete tamariki me ngā tohutohu inenga hei whakaiti i ngā mōrearea horomia. Whai muri i ngā wero ture tata nei, kua whakapakarihia e ngā rōpū ahumahi ngā aratohu mō te whakamahinga haumaru: me tirotiro ngā pakeke i ngā tamariki kei raro iho i te 6 tau te pakeke, ā, me tino whai i ngā rahinga paraihe niho kua tūtohutia (he rite ki te witi raihi, he rite rānei ki te rahi pī).

Haunga ngā waitohu rongonui, kei te tuku ētahi kamupene "taiao" motuhake rānei i ngā paraihe niho kore-hauora hei whakatutuki i te hiahia o ngā kaihoko. Heoi, kāore ēnei hua e kī ana he ārai i te pirau, ā, kāore pea e rite te taumata o te ārai pirau. I te nuinga, he mārama te tūnga o te umanga: ko te paraihe niho ko te hauora te parepare tuatahi tino whai hua mō ngā pirau niho, ā, ka haere tonu ngā kaihanga ki te whakarei ake i te tapanga, te takai, me ngā mahi mātauranga kia pai ai te whakamahinga haumaru me te whai whakaaro.

Ngā Tirohanga Ao mō te Whakahaere i te Pūhaumāota

I te ao whānui, he whānui te whakaae mō ngā painga o te paraihe niho whai fluoride, ahakoa he rerekē ngā taipitopito ture. I roto i te Kotahitanga o Ūropi, ka whakarōpūtia ngā paraihe niho hei mea whakapaipai, ā, ka herea ki te 1,500 ppm te fluoride. He maha ngā wā kei roto i ngā hanganga tamariki te 500–600 ppm hei whakaiti i te mōrearea o te fluorosis. I te mea e 3% noa iho o ngā tāngata Ūropi e whiwhi ana i te wai whai fluoride, he mea nui te paraihe niho whai fluoride ki te ārai i ngā poka. He rite ngā ture a Kanata ki te US, e kī ana i te paraihe niho ārai poka hei rongoā ka taea te hoko kore-tohu, ā, e tautoko ana i ngā aratohu horopeta ōrite mō ngā tamariki. Ka whakaaetia e Ahitereiria te 1,450 ppm o te fluoride i roto i te paraihe niho, ā, e tautoko ana i te whakawhai fluoride wai hapori. E taunaki ana ngā rōpū o te ao, tae atu ki te World Health Organization, kia whakamahia te paraihe niho me te 1,000–1,500 ppm o te fluoride i ngā rohe kāore i te whai fluoride wai. I roto i te poto, ahakoa he rerekē te whakarōpūtanga me te whakatinanatanga, e mōhiotia whānuitia ana te paraihe niho whai fluoride he mea nui mō te hauora o te waha.