Chifukwa Chake USA Ikutengera Fluoride mu Mano Otsukira Mano Mozama

Chifukwa Chake Mankhwala Otsukira Mano a Fluoride Amagwiritsidwa Ntchito Kwambiri

Mankhwala otsukira mano otchedwa fluoride ali paliponse ku United States chifukwa atsimikiziridwa kuti amateteza mabowo ndipo amavomerezedwa kwambiri ndi mabungwe otsogola azaumoyo wa mano ndi anthu onse. Akuluakulu azaumoyo, kuphatikizapo Centers for Disease Control and Prevention (CDC), amati fluoride ndiye amachititsa kuti chiwerengero cha mano ovunda chichepe kwambiri. Masiku ano, mankhwala otsukira mano opitilira 95% omwe amagulitsidwa ku US ali ndi fluoride—nthawi zambiri monga sodium fluoride kapena sodium monofluorophosphate pafupifupi 1,000–1,100 ppm. Akatswiri amavomereza kuti kuphatikiza madzi okhala ndi fluoride ndi mankhwala otsukira mano otchedwa fluoride kumapereka chitetezo chabwino kwambiri ku kuwola poyerekeza ndi kugwiritsa ntchito njira iliyonse yokha. Zotsatira zake, kutsuka mano kawiri patsiku ndi mankhwala otsukira mano otchedwa fluoride omwe amavomerezedwa ndi ADA kwakhala njira yodziwika bwino pafupifupi mabanja onse aku America.

Mbiri Yakale ya Fluoride mu Umoyo Wamkamwa ku US

Kugwiritsa ntchito fluoride mu mano aku America kunayamba kumayambiriro kwa zaka za m'ma 1900, pamene Dr. Frederick McKay adazindikira "Colorado Brown Stain," yomwe pambuyo pake idalumikizidwa ndi fluoride yachilengedwe yambiri m'madzi. Mu 1945, Grand Rapids, Michigan idakhala mzinda woyamba padziko lonse lapansi kuyika fluoride m'madzi a anthu onse, zomwe zidapereka umboni womveka bwino wakuti fluoride imachepetsa mabowo. Pofika m'ma 1970, anthu oposa 100 miliyoni aku America adalandira madzi okhala ndi fluoride, ndipo kafukufuku adasintha mwachangu kugwiritsa ntchito fluoride mu mankhwala otsukira mano.

Mu 1956, Procter & Gamble adayambitsa Crest, mankhwala otsukira mano oyamba opangidwa ndi fluoride omwe adagulitsidwa mdziko lonse. Crest idalandira Seal of Acceptance ya American Dental Association mu 1960, zomwe zidapangitsa kuti makampani ena atsatire. Pofika m'ma 1970, fluoride idakhazikitsidwa ngati chogwiritsira ntchito cholimbanira ndi ziphuphu, ndipo pafupifupi mankhwala onse otsukira mano omwe amapezeka m'mashelefu aku US anali ndi fluoride.

Kugwiritsa Ntchito ndi Malamulo

Kugwiritsa Ntchito Mankhwala Otsukira Mano a Fluoride ku America

Pambuyo poti Crest yayamba bwino, msika wa mankhwala otsukira mano ku US unasintha mofulumira. Pofika m'ma 1980, pafupifupi mtundu uliwonse waukulu unkapereka mankhwala otsukira mano otchedwa fluoride, ndipo anthu ambiri anayamba kugwiritsa ntchito mankhwala otsukira mano. Kafukufuku wa m'ma 1990 anasonyeza kuti ana ndi akuluakulu aku America opitirira 90% ankagwiritsa ntchito mankhwala otsukira mano otchedwa fluoride. Masiku ano, m'masitolo akuluakulu mumakhala mankhwala otsukira mano otchedwa fluoride, chifukwa cha malangizo amphamvu ochokera kwa madokotala a mano komanso lamulo lakuti mankhwala otsukira mano aliwonse okhala ndi ADA Seal ayenera kukhala ndi fluoride.

Ndondomeko Yolamulira Yolamulira Fluoride mu Mankhwala Otsukira Mano

Ku United States, mankhwala otsukira mano otchedwa fluoride amalamulidwa ngati mankhwala ogulitsidwa kunja kwa kampani (OTC) motsatira Food and Drug Administration's (FDA) Anticaries Monograph (21 CFR 355). FDA imalola mankhwala enaake a fluoride—monga sodium fluoride, sodium monofluorophosphate, ndi stannous fluoride—pa kuchuluka kolamulidwa. Mankhwala otsukira mano okhazikika amakhala ndi 850–1,150 ppm fluoride (0.085%–0.115% fluoride ion). Gulu la "high-fluoride" (mpaka 1,500 ppm) limaloledwa pokhapokha ngati pali machenjezo ena owonjezera achitetezo; chilichonse choposa 1,500 ppm chimafuna mankhwala olembedwa ndi dokotala.

Zofunikira pa kulemba mayina ndizokhwima mofanana. Mankhwala otsukira mano ayenera kudzizindikiritsa momveka bwino kuti ndi "osagwira ntchito" kapena "fluoride" m'dzina la mankhwalawo, kulemba chosakaniza cha fluoride chogwira ntchito ndi kuchuluka kwake, ndikuwonetsa chenjezo la chitetezo cha ana pansi pa "Zowona Zamankhwala": "Sungani pamalo omwe ana osakwana zaka 6 sangafikire. Ngati mwangozi mwameza mankhwala ochulukirapo kuposa omwe amagwiritsidwa ntchito potsuka mano, pitani kuchipatala kapena funsani Poison Control Center nthawi yomweyo." Malangizo ogwiritsira ntchito—monga kutsuka mano kawiri patsiku ndi kuyang'anira ana osakwana zaka 6—akulamulidwanso. Malamulo awa akutsimikizira kuti ogula amalandira malangizo omveka bwino okhudza kugwiritsa ntchito fluoride moyenera komanso kotetezeka.

Kuchita bwino ndi chitetezo

Ubwino ndi Kugwira Ntchito kwa Anthu Onse pa Zaumoyo

Kafukufuku wa zaka makumi ambiri akusonyeza kuti mankhwala otsukira mano okhala ndi fluoride amachepetsa kwambiri kuwola kwa mano. Ndemanga yodziwika bwino kuchokera ku Cochrane Collaboration inapeza kuti mankhwala otsukira mano okhala ndi fluoride (≥1,000 ppm) amateteza ana kuti asamabowole mano bwino kuposa njira zina zopanda fluoride. Pa avareji, kutsuka mano okhala ndi fluoride kawiri patsiku kumachepetsa chiopsezo cha kuonda ndi 14-30%. Mphamvu ya fluoride pakhungu imathandiza kubwezeretsa mchere wa enamel ndipo, ikaphatikizidwa ndi madzi okhala ndi fluoride, imatha kuchepetsa kuwola ndi 25% pamlingo wa anthu. Zotsatirazi zawonetsedwa m'maiko padziko lonse lapansi, kutsimikizira kuti mankhwala otsukira mano okhala ndi fluoride ndi imodzi mwa njira zotsika mtengo kwambiri zochizira matenda a mano.

Nkhawa ndi Mikangano pa Zachitetezo

Chodetsa nkhawa chachikulu ndi chitetezo cha mano otsukira mano okhala ndi fluoride ndi kuchuluka kwa mano omwe ana aang'ono amakhala nawo, zomwe zingayambitse mano otsukira mano (mano oyera kapena a bulauni). Deta ya ku US ya 1999-2004 ikusonyeza kuti pafupifupi 40% ya achinyamata ali ndi vuto la fluorosis, ngakhale kuti nthawi zambiri amakhala ofatsa komanso okongoletsa. Pofuna kuchepetsa chiopsezo, akatswiri azaumoyo amalimbikitsa kugwiritsa ntchito mankhwala otsukira mano okhala ndi fluoride kwa ana osakwana zaka 3 ndi fluoride kwa ana azaka zapakati pa 3-6, ndi kuyang'aniridwa ndi akuluakulu kuti asameze.

Kupha poizoni wa fluoride kuchokera ku mano otsukira mano ndi kosowa kwambiri, komwe kumafuna kumwa kwambiri. Mabungwe akuluakulu azaumoyo—kuphatikizapo CDC, ADA, ndi American Academy of Pediatrics—akutsimikizira kuti mano otsukira mano otsukira mano otsukira mano ndi otetezeka akagwiritsidwa ntchito monga momwe adalangizidwira. Ngakhale kuti kafukufuku wochepa wabweretsa mafunso okhudza momwe fluoride imakhudzira kukula kwa mitsempha pamene munthu akhudzidwa kwambiri ndi mano, kukhudzana kumeneku kumaposa kwambiri zomwe mwana angalandire kuchokera ku mano otsukira mano kapena madzi okhala ndi fluoride.

Mwachidule

Makolo akatsatira malangizo ogwiritsira ntchito omwe ali ndi zilembo, chiopsezo cha kuwonongeka kwa thupi chimakhala chochepa.

Zochita Zandale ndi Zamalamulo Zaposachedwa ku US

Mu 2024 ndi 2025, mayiko angapo adasankha kuletsa kugwiritsa ntchito madzi oundana m'madera osiyanasiyana—chinthu chomwe chimakhudza anthu ambiri pogwiritsa ntchito mankhwala otsukira mano otchedwa fluoride. Mwachitsanzo, Utah ndi Florida zidapereka malamulo oletsa kugwiritsa ntchito madzi oundana, zomwe zidayambitsa kutsutsa kwakukulu kuchokera kwa akatswiri a mano ndi azaumoyo omwe amachenjeza kuti kuchotsa fluoride kungawonjezere mabowo, makamaka pakati pa ana. Woweruza milandu wa boma adalamulanso EPA kuti iwunikenso miyezo ya fluoride m'madzi akumwa, ponena za kafukufuku wokhudza zotsatira zomwe zingachitike pakukula kwa mitsempha. Ngakhale kuti chigamulochi chikukambidwa, CDC ndi ADA adatsimikiziranso kuti kugwiritsa ntchito fluoride kudakali chimodzi mwa zinthu zabwino kwambiri zomwe zachitika pa thanzi la anthu m'mbiri ya US.

Kuwunikanso malamulo okhudza malonda a mano otsukira mano kwakulanso. Kumayambiriro kwa chaka cha 2025, milandu yokhudza magulu inaperekedwa motsutsana ndi opanga mankhwala otsukira mano akuluakulu, ponena kuti malonda “achinyengo” kwa ana—madandaulo akuti mankhwala otsukira mano okhala ndi zokometsera, okhala ndi zilembo za katuni amalimbikitsa kumeza ndi kusokeretsa makolo. Texas Attorney General inayambitsa kafukufuku wokhudza ngati kulongedza ndi kutsatsa kumaphwanya malangizo a FDA pankhani yogwiritsa ntchito fluoride. ADA inayankha pobwerezanso kuti mankhwala otsukira mano opepuka, omwe amagwiritsidwa ntchito moyang'aniridwa, ndi otetezeka komanso ogwira ntchito.

Kuyankha kwa Makampani ndi Njira Zabwino Kwambiri

Opanga mankhwala otsukira mano akuluakulu—monga Colgate-Palmolive ndi Procter & Gamble—amagogomezera kutsatira kwambiri zofunikira za FDA, kuyesa zinthu mwamphamvu, ndi kulemba zilembo zomveka bwino. Amawonetsa bwino ADA Seal of Acceptance pamapaketi kuti atsimikizire ogula kuti atsimikizire kuti anthu ena avomereza. Opanga amaphatikizanso zipewa zosagwira ana ndi malangizo a mlingo kuti achepetse zoopsa zomeza. Pambuyo pa zovuta zaposachedwa zamalamulo, magulu amakampani alimbikitsa malangizo okhudza kugwiritsa ntchito mosamala: akuluakulu ayenera kuyang'anira ana osakwana zaka 6, ndipo kuchuluka kwa mankhwala otsukira mano (a mpunga kapena nandolo) kuyenera kutsatiridwa mosamala.

Kuwonjezera pa makampani akuluakulu, makampani ena "achilengedwe" kapena apadera amapereka mankhwala otsukira mano opanda fluoride kuti akwaniritse zosowa za ogula. Komabe, mankhwalawa sali ndi zifukwa zoti angayambitse matenda ndipo sangapereke mlingo womwewo woletsa kuwola. Ponseponse, malingaliro a makampaniwa ndi omveka bwino: mankhwala otsukira mano okhala ndi fluoride akadali chitetezo chothandiza kwambiri ku mabowo, ndipo opanga apitiliza kuwonjezera zilembo, kulongedza, ndi maphunziro kuti atsimikizire kuti akugwiritsidwa ntchito mosamala komanso mwanzeru.

Malingaliro Padziko Lonse Pankhani Yolamulira Fluoride

Padziko lonse lapansi, pali mgwirizano waukulu pa ubwino wa mankhwala otsukira mano okhala ndi fluoride, ngakhale kuti mfundo za malamulo zimasiyana. Mu European Union, mankhwala otsukira mano amagawidwa ngati zodzoladzola ndipo amakhala ndi fluoride ya 1,500 ppm. Mankhwala a ana nthawi zambiri amakhala ndi 500-600 ppm kuti achepetse chiopsezo cha fluorosis. Popeza pafupifupi 3% ya anthu aku Europe amalandira madzi okhala ndi fluoride, mankhwala otsukira mano okhala ndi fluoride amagwira ntchito yofunika kwambiri popewa kutsekeka kwa m'mimba. Malamulo aku Canada amafanana ndi a ku US, akuwona mankhwala otsukira mano okhala ndi fluoride ngati mankhwala ogulitsidwa kunja kwa chipatala ndipo amavomereza malangizo ofanana a mlingo kwa ana. Australia imalola fluoride ya 1,450 ppm mu mankhwala otsukira mano ndipo imathandizira kwambiri kugwiritsa ntchito fluoride m'madzi ammudzi. Mabungwe apadziko lonse lapansi, kuphatikiza World Health Organisation, amalimbikitsa kugwiritsa ntchito mankhwala otsukira mano okhala ndi fluoride ya 1,000-1,500 ppm m'madera omwe alibe fluoride yamadzi. Mwachidule, ngakhale kuti magulu ndi kugwiritsa ntchito zimasiyana pang'ono, mankhwala otsukira mano okhala ndi fluoride amadziwika kuti ndi ofunikira pa thanzi la pakamwa.

Mapeto & Kuyitanitsa Kuchitapo Kanthu

Mankhwala otsukira mano okhala ndi fluoride akadali maziko a njira zochizira matenda a mkamwa ku United States. Akuluakulu azaumoyo—kuphatikizapo CDC, ADA, ndi American Academy of Pediatrics—akupitirizabe kulimbikitsa kutsuka mano kawiri patsiku ndi mankhwala otsukira mano okhala ndi fluoride ndipo akugogomezera kuyang'aniridwa koyenera ndi mlingo wa ana aang'ono. Ngakhale kuti pali mikangano yambiri, umboni wa sayansi wa zaka zambiri ukutsimikizira kuti mankhwala otsukira mano okhala ndi fluoride ndi otetezeka komanso othandiza kwambiri popewa mabowo. Pamene mfundo zokhudzana ndi madzi zikusintha, mankhwala otsukira mano akhalabe njira yabwino kwambiri yotetezera mano awo kwa anthu aku America.

IVISMILELimalimbikitsa ogula onse kusankha mankhwala otsukira mano otchedwa fluoride omwe amavomerezedwa ndi ADA ndikutsatira malangizo olembedwa: gwiritsani ntchito kuchuluka kwa mpunga kwa ana osakwana zaka 3, kuchuluka kwa nandolo kwa ana azaka 3-6, ndikuyang'anira kutsuka mano. Mwa kuphatikiza kugwiritsa ntchito mankhwala otsukira mano moyenera ndi zakudya zoyenera komanso kuyezetsa mano nthawi zonse, mabanja amatha kukulitsa thanzi la mkamwa ndikusangalala ndi kumwetulira kowala komanso kwathanzi kwa zaka zikubwerazi.