Chifukwa chiyani USA Imatengera Fluoride mu Otsukira Mano Mozama

Mbiri Yakale ya Fluoride ku US Oral Health

Kugwiritsiridwa ntchito kwa fluoride m'chipatala cha mano ku America kudayamba chakumayambiriro kwa zaka za m'ma 1900, pamene Dr. Frederick McKay anazindikira kuti "Colorado Brown Stain," pambuyo pake kugwirizana ndi fluoride wachilengedwe m'madzi. Mu 1945, Grand Rapids, Michigan idakhala mzinda woyamba padziko lonse lapansi kutulutsa madzi amtundu wa fluoride, ndikupereka umboni womveka bwino wakuti fluoride imachepetsa mabowo. Pofika zaka za m'ma 1970, anthu aku America opitilira 100 miliyoni adalandira madzi a fluoridated, ndipo kafukufuku adasintha mwachangu kuyika fluoride mu mankhwala otsukira mano.

Mu 1956, Procter & Gamble adayambitsa Crest, mankhwala otsukira mano oyamba kugulitsidwa padziko lonse lapansi. Crest adalandira chisindikizo cha American Dental Association's Seal of Acceptance mu 1960, zomwe zidapangitsa kuti ma brand ena atsatire. Pofika m'zaka za m'ma 1970, fluoride idakhazikitsidwa mokhazikika ngati njira yolimbana ndi patsekeke, ndipo pafupifupi mankhwala otsukira m'mano aliwonse pamashelufu aku US anali ndi fluoride.

Kugwiritsa Ntchito ndi Kuwongolera

Kukhazikitsidwa kwa Fluoride Toothpaste ku American Market

Pambuyo poyambitsa bwino Crest, msika wotsukira mano ku US unasintha mwachangu. Pofika m'zaka za m'ma 1980, pafupifupi mtundu uliwonse waukulu unkapereka mankhwala a fluoride, ndipo kutengera kwa ogula kunawonjezeka. Kafukufuku wamsika m'zaka za m'ma 1990 adawonetsa kuti 90% ya ana ndi akulu aku America amatsuka ndi mankhwala otsukira mano a fluoride. Masiku ano, tinjira tating'onoting'ono ta masitolo akuluakulu timakhala ndi zinthu zopangidwa ndi fluoride, motsogozedwa ndi malingaliro amphamvu ochokera kwa madokotala a mano komanso kufunikira kwakuti mankhwala otsukira mano omwe ali ndi ADA Seal ayenera kukhala ndi fluoride.

Regulatory Framework Yoyang'anira Fluoride mu Otsukira Mano

Ku United States, mankhwala otsukira mano a fluoride amawunikidwa ngati mankhwala ogulitsira (OTC) pansi pa Food and Drug Administration's (FDA) Anticaries Monograph (21 CFR 355). A FDA amalola mankhwala enaake a fluoride-monga sodium fluoride, sodium monofluorophosphate, ndi stannous fluoride-pamalo olamulidwa. Mankhwala otsukira mano okhazikika amakhala pafupifupi 850-1,150 ppm fluoride (0.085% -0.115% fluoride ion). Gulu la "high-fluoride" (mpaka 1,500 ppm) limaloledwa kokha ndi machenjezo owonjezera a chitetezo; chilichonse pamwamba pa 1,500 ppm chimafuna kulembedwa.

Zofunikira zolembera ndizokhwima chimodzimodzi. Mankhwala otsukira m'mano ayenera kudzizindikiritsa bwino kuti ndi “anticavity” kapena “fluoride” m’dzina la mankhwalawo, atchule chosakaniza cha fluoride ndi kuchuluka kwake, ndi kusonyeza chenjezo la chitetezo cha mwana pamutu wakuti “Zowonadi Zamankhwala”: “Khalani kutali ndi ana osafika zaka 6. Ngati zambiri zomwe zimagwiritsidwa ntchito potsuka ndi kumezedwa mwangozi, pemphani thandizo lachipatala kapena funsani mwamsanga Malo Oletsa Poizoni.” Malangizo ogwiritsira ntchito—monga kutsuka burashi kawiri tsiku lililonse ndi kuyang’anira ana ochepera zaka 6—alinso ndi mphamvu. Malamulowa amawonetsetsa kuti ogula amalandira malangizo omveka bwino pakugwiritsa ntchito motetezeka komanso kothandiza kwa fluoride.

Kuchita bwino ndi chitetezo

Ubwino Waumoyo Pagulu ndi Kuchita Bwino

Kafukufuku wazaka makumi angapo akuwonetsa kuti mankhwala otsukira mano a fluoride amachepetsa kwambiri kuwola. Ndemanga yodziwika bwino yochokera ku Cochrane Collaboration idapeza kuti mankhwala otsukira mano a fluoride (≥1,000 ppm) amalepheretsa ming'oma mwa ana bwino kuposa njira zina zopanda fluoride. Pa avareji, kutsuka m'kamwa kawiri patsiku ndi mankhwala otsukira mano a fluoride kumachepetsa chiopsezo cha 14-30%. Zomwe zimachitika pamutu wa fluoride zimathandizira kubwezeretsa enamel ndipo, zikaphatikizidwa ndi madzi okhala ndi fluoridated, zimatha kuchepetsa kuola ndi 25% pamlingo wa anthu. Zotsatirazi zawonetsedwa m'maiko padziko lonse lapansi, kutsimikizira kuti mankhwala otsukira mano a fluoride ndi amodzi mwa njira zotsika mtengo kwambiri paumoyo wa anthu paumoyo wapakamwa.

Zokhudza Chitetezo ndi Zotsutsana

Chomwe chimadetsa nkhawa kwambiri ndi mankhwala otsukira m'mano a fluoride ndikudziwikiratu kwa ana ang'onoang'ono, zomwe zingayambitse meno fluorosis (mano oyera kapena ofiirira). Deta yaku US kuyambira 1999-2004 ikuwonetsa kuti pafupifupi 40% ya achinyamata amawonetsa kuchuluka kwa fluorosis, ngakhale kuti nthawi zambiri amakhala ofatsa komanso odzola. Pofuna kuchepetsa chiopsezo, akatswiri a zaumoyo amalimbikitsa kugwiritsa ntchito mankhwala otsukira mano a "mpunga-tirigu" kwa ana osapitirira zaka 3 ndi kuchuluka kwa "pea-size" kwa zaka 3-6, kuyang'aniridwa ndi akuluakulu kuti asameze.

Pachimake poyizoni wa fluoride kuchokera ku mankhwala otsukira mano ndi osowa kwambiri, kumafuna kumwa mochuluka. Mabungwe otsogola azaumoyo — kuphatikiza CDC, ADA, ndi American Academy of Pediatrics — amatsimikizira kuti mankhwala otsukira mano a fluoride ndi otetezeka akagwiritsidwa ntchito monga momwe akulangizidwa. Ngakhale kafukufuku wochepa wadzutsa mafunso okhudza momwe fluoride imakhudzira neurodevelopment pamilingo yowonekera kwambiri, kuwonekera kumeneku kumaposa zomwe mwana angalandire kuchokera ku mankhwala otsukira mano kapena madzi a fluoridated.

Mwachidule

Makolo akamatsatira malangizo ogwiritsira ntchito, chiopsezo cha kuwonongeka kwadongosolo sichitha.

Zaposachedwa Zandale & Zazamalamulo ku US

Mu 2024 ndi 2025, mayiko angapo adasamukira kuletsa kusungunuka kwamadzi ammudzi - zomwe zili ndi zotsatira zina pakudalira anthu pamankhwala otsukira mano a fluoride. Mwachitsanzo, Utah ndi Florida adapereka malamulo oletsa madzi a fluoridation, zomwe zinayambitsa kutsutsa kwakukulu kuchokera kwa akatswiri a mano ndi zaumoyo omwe amachenjeza kuti kuchotsa fluoride kungapangitse ming'oma, makamaka pakati pa ana. Woweruza boma adalamulanso EPA kuti iwunikenso miyezo yamadzi akumwa a fluoride, kutchulapo kafukufuku wokhudzana ndi zotsatira za neurodevelopmental. Ngakhale kuti chigamulochi chikufunsidwa, CDC ndi ADA zatsimikiziranso kuti fluoridation idakali imodzi mwazopambana kwambiri pazaumoyo wa anthu m'mbiri ya US.

Kufufuza kwalamulo pa malonda otsukira mano nawonso kwakula. Kumayambiriro kwa chaka cha 2025, milandu yamagulu idaperekedwa kwa opanga mankhwala otsukira mano akuluakulu, ponena kuti malonda "achinyengo" kwa ana - amanena kuti mankhwala otsukira mano okometsera, opangidwa ndi zojambula amalimbikitsa kumeza ndi kusokeretsa makolo. Texas Attorney General adayambitsa kafukufuku wowona ngati kuyika ndi kutsatsa kumaphwanya malangizo a FDA pakugwiritsa ntchito fluoride. ADA adayankha ndikubwerezanso kuti mankhwala otsukira mano a fulorosenti, omwe amagwiritsidwa ntchito moyang'aniridwa, ndi otetezeka komanso othandiza.

Kuyankha Kwamakampani & Zochita Zabwino Kwambiri

Opanga mankhwala otsukira mano akuluakulu—monga Colgate-Palmolive ndi Procter & Gamble—amagogomezera kutsatira mosamalitsa zofunika za FDA monograph, kuyezetsa koyenera, ndi kulemba momveka bwino. Amawonetsa bwino ADA Seal of Acceptance pamapaketi kuti atsimikizire ogula kutsimikizika kwa chipani chachitatu. Opanga amaphatikizanso zipewa zolimbana ndi ana ndi malangizo a mlingo kuti achepetse kuopsa kwa kumeza. Potsatira zovuta zaposachedwa zamalamulo, magulu amakampani alimbikitsa malangizo okhudza kugwiritsa ntchito moyenera: akuluakulu ayenera kuyang'anira ana osakwana zaka 6, ndipo zotsukira mkamwa zovomerezeka (tirigu kapena nandolo) ziyenera kutsatiridwa mosamalitsa.

Kuphatikiza pa mitundu yodziwika bwino, makampani ena "achilengedwe" kapena apadera amapereka mankhwala otsukira mano opanda fluoride kuti akwaniritse zofuna za ogula. Komabe, zinthuzi sizikhala ndi zonena za anticavity ndipo sizingapereke mlingo womwewo wa kupewa kuwola. Ponseponse, momwe makampaniwa akuwonera: mankhwala otsukira mano a fluoride akadali njira yabwino kwambiri yodzitchinjiriza pamabowo, ndipo opanga apitiliza kulimbikitsa zolemba, kulongedza, ndi zoyeserera kuti awonetsetse kuti akugwiritsa ntchito mwanzeru.

Malingaliro Padziko Lonse pa Fluoride Regulation

Padziko lonse lapansi, pali mgwirizano waukulu pazabwino za mankhwala otsukira mano a fluoride, ngakhale kuti malamulo amasiyana amasiyana. Ku European Union, mankhwala otsukira mano amalembedwa ngati zodzoladzola ndipo amakhala ndi 1,500 ppm fluoride. Mankhwala a ana nthawi zambiri amakhala ndi 500-600 ppm kuti achepetse chiopsezo cha fluorosis. Popeza pafupifupi 3% yokha ya anthu aku Europe amalandira madzi okhala ndi fluoride, mankhwala otsukira mano a fluoride amagwira ntchito yofunika kwambiri popewa kutsekeka. Malamulo aku Canada amafanana ndi US, kuchitira mankhwala otsukira mano ngati mankhwala ogulitsa komanso kuvomereza malangizo ofanana a ana. Australia imalola mpaka 1,450 ppm fluoride mu mankhwala otsukira mano ndipo imathandizira mwamphamvu kusungunuka kwamadzi ammudzi. Mabungwe apadziko lonse lapansi, kuphatikiza bungwe la World Health Organisation, amalimbikitsa kugwiritsa ntchito mankhwala otsukira mano okhala ndi 1,000–1,500 ppm fluoride m'madera omwe alibe fluoridation yamadzi. Mwachidule, ngakhale kugawa ndi kukhazikitsa kumasiyana pang'ono, mankhwala otsukira mano a fluoride amadziwika padziko lonse lapansi kuti ndi ofunikira paumoyo wapakamwa.