**Hu̍t-hòa-bu̍t** (*fluoride*) kap chiù-khí ê koan-hē tī 20 sè-kì khah-chá ê sî chiah hō· lâng hoat-hiān, āu--lâi chiok-chē liû-hêng-pēⁿ-ha̍k ê gián-kiù chèng-si̍t hu̍t-hòa-bu̍t tī ī-hông chiù-khí ê hāu-kó.

Chok-iōng ki-choán
------------------

Chèng-khak ê chok-iōng ki-choán iah m̄-chai-iáⁿ; i khó-lêng sī thàu-kòe éng-hióng khí-iū-chit ê kiat-kàu, kái-piàn chhùi-khí ê hêng-thāi, kap ek-chè khí-khún-pan chit 3-chióng hoat-tō· lâi ī-hông chiù-khí.

### Hu̍t-hòa-bu̍t kap khí-iū-chit

Khí-iū-chit chú-iàu iû calcium hydroxyapatite, (Ca5[(PO4)3OH]) chit-chióng chiⁿ-thé lâi cho·-sêng, i nā tú-tio̍h hu̍t chiâⁿ gâu thoat-li̍h chhut *hydroxyl group*, chôaⁿ piàn-sêng calcium fluoroapatite, ( Ca5[(PO4)3F]). Hydroxyapatitite pí fluorapatitite khah iông-ì iông-kái tī sng. 

Hu̍t-hòa-bu̍t ē pang-chàn khí-iū-chit ê koh-kài-hòa (*recalcification*); khí-iū-chit tú-tio̍h sng ē thoat-kài-hòa (*decalcification*), jiân-āu tī chhùi-nōa tiong koh-kài-hòa, 1-lâi-1-khì chi-kan nā thoat-kài-hòa khah-chē tio̍h chiù-khí, nā koh-kài-hòa khah-chē tio̍h-bē chiù-khí.

### Hu̍t-hòa-bu̍t kap chhùi-khí hêng-thāi

Chhùi-khí hoat-io̍k ê sî-kî só· chiah ê hu̍t ē sió-kóa kái-piàn khí-koan ê hêng-thāi, pí-jû khah khoah ê sió-khut-á kap li̍h-phāng, khah-bô hiah chiam ê kā-thâu. Án-ne ē kiám-chió sió-khut-á kap li̍h-phāng ê chiù-khí.

### Hu̍t-hòa-bu̍t kap khí-khún-pan

Si̍t-giām hián-sī hu̍t tùi khí-khún-pan ū 2-chióng chok-iōng, ap-chè khí-khún-pan ê hêng-sêng kap kàng-kē khí-khún-pan lāi-té kàⁿ-sò· ê chok-iōng. Hu̍t kàng-kē chhùi-nōa ê nńg-pe̍h-chit tîm-chek tī chhùi-khí piáu-bīn ê ki-hōe, in-chhú kiám-chió pellicle ê hêng-sêng, ah pellicle sī khí-khún-pan hêng-sêng chho·-kî só· su-iàu ê mi̍h-kiāⁿ. 
Kēng-ka hō· lâng ū hèng-chhù--ê sī hu̍t tī khí-khún-pan ê thn̂g-hun-kái (*glycolysis*) ê éng-hióng. Koân lông-tō· ê hu̍t ē-tit kiám-chió khí-khún-pan lâi sán-seng sng.

Hu̍t ê io̍h-bu̍t tōng-le̍k-ha̍k (*pharmacokinetics of fluoride*)
----------------------------------------------------------------

Sin-thé tùi fluorine ê khip-siu lâi-chū ím-chúi, chia̍h-mi̍h, kap khong-khì. M̄-koh chú-iàu sī ùi ūi-tn̂g khip-siu, khip-siu 1-tiám-cheng liáu-āu to̍h ta̍t-kàu hoeh-tiong siāng-koân ê lông-tō·, 3chì 6-tiam-cheng chi-lāi hoeh-tiong lông-tō· tio̍h tńg-lâi chèng-siông ê lông-tō·. Tāi-iok 50-pha ê khip-siu ê fluorine tī 24-tiám-cheng chi-lāi ē ùi phàng-jiō, lâu-kōaⁿ, kap tōa-piān pâi-chhut. Lâu-tī sin-thé ê fluorine 99-pha chìn-ji̍p kài-hòa ê cho·-chit, chhùi-khí nā iàu-teh hoat-io̍k fluorine mā-ē chìn-ji̍p chhùi-khí kò·-chō tiong. Fluorine ē hō· thai-pôaⁿ (*placenta*) pō·-hūn chó·-tóng--khí-lâi, in-chhú thàu-kòe bô-thé chiah ê fluorine beh-lâi ka-kiông gín-á ê chhùi-khí ê hāu-kó pēng-bô khak-tēng.

Hu̍t-hòa-bu̍t si-ú
------------------

Hu̍t-hòa-bu̍t si-ú ēt-tit hē-thóng-sèng chioh lim-chúi, gû-leng, si̍t-iâm thiam-ka hu̍t-hòa-bu̍t, hu̍t-hòa-bu̍t ê io̍h-oân-á, io̍h-chúi, he̍k-chiá-sī kio̍k-pō·-sèng chioh hu̍t-hòa-bu̍t iông-sio̍h, hu̍t-chhat (*varnish*), khí-ko, lo̍k-chhùi-chúi lâi oân-sêng.

### Ím-chúi-ka-hu̍t (water fluoridation)

Ím-iōng-chúi ka hu̍t-hòa-bu̍t tùi ī-hông chiù-khí ê kong-hāu sī kong-jīn ê sū-si̍t, ia̍h-sī siāng séng-chîⁿ siāng ū-hāu ê hoat-tō·. 

### Hu̍t pó·-chhiong-che

Ím-iōng-chúi bô ka hu̍t-hòa-bu̍t he̍k-chiá-sī hâm-hu̍t lông-tō· bô-kàu ê só·-chāi ē-sài--chhit thàu-kòe thun-chia̍h io̍h-oân-á, io̍h-che, he̍k-chiá-sī ka-kong-chia̍h-mi̍h lâi pó·-chhiong hu̍t-hòa-bu̍t, chhin-chhiūⁿ hu̍t-tēng (*tablet*), hu̍t-thn̂g-tēng (*lozeng*e), hu̍t-tih-che (*drop*), chhiūⁿ-ni-thn̂g-ka-hu̍t, vitamin-ka-hu̍t, iâm-ka-hu̍t, gû-leng-ka-hu̍t, mī-hún-ka-hu̍t, thn̂g-ka-hu̍t. 

### Hu̍t-ka

Lîm-chhn̂g choan-gia̍p sú-iōng ê hu̍t-ka í soan-hòa lîn-sng-hu̍t (*acidulated phosphate fluoride, APF*) siāng phó·-phiàn, hâm-hu̍t lông-tō· sī 1.23% (12,300 ppm), lēng-gōa koh-ū sodium fluoride (0.9% [9,000 ppm] fluoride). Ē-sài tiàm chhù--nih ka-tī sú-iōng ê hu̍t-ka hâm-hu̍t lông-tō· khah-kē, hó-pí-kóng hâm 1.1% (4,950 ppm) fluoride ê sodium fluoride, kap hâm 0.4% (960 ppm) ê stannous fluoride. 

### Hu̍t-iông-sio̍h

Hu̍t-iông-sio̍h sêng-hūn ū sodium fluoride, stannous fluoride, he̍k soan-hòa lîn-sng-hu̍t, hu̍t ê lông-tō· sī 12,300 ppm. 

### Hu̍t-chhat

Hu̍t-chhat (*varnish*) ê sêng-hūn ū sodium fluoride, hu̍t lông-tō· 5% (22,600 ppm), chhiūⁿ Duraphat, Cavity Shield, Duraflor. Koh-ū difluorsilane, hâm hu̍t 0.1% (1,000 ppm), chhiūⁿ Fluor Protector. 

### Hâm-hu̍t-khí-ko

Hâm-hu̍t-khí-ko ê sêng-hūn tāi-to-sò· sī sodium monofluorophosphate (MFP), lông-tō· ài 0.1% (1,000 ppm) í-siōng. 

### Hâm-hu̍t-lo̍k-chhùi-chúi

Hâm hu̍t ê lo̍k-chhùi-chúi sī 1-chióng kán-tan, an-choân, sio̍k koh iông-ì hông chiap-siū ê hoat-tō·, it-poaⁿ phòe-ha̍p tī sú-iōng kòe hâm hu̍t ê khí-ko luh chhùi-khí liáu-āu chiah-koh sú-iōng, ī-hông chiù-khí hāu-kó ē-tit ta̍t-kàu 35%. In-ūi tī lo̍k-chhùi liáu-āu ài phùi--chhut-lâi, ūi-tio̍h phiah-bián siuⁿ sè-hàn ê gín-á thun-chia̍h, só·-í bô kiàn-gī sú-iōng tī 6-hòe í-hā ê gín-á. I-chiàu hâm hu̍t ê lông-tō· ē-sái kā hun-chòe 2-lūi : 

* Koân lông-tō· : hu̍t ê lông-tō· 905 ppm chó-iū, 1-lé-pài sú-iōng 1-pái tio̍h ē-ēng--ē.
* Kē lông-tō· : hu̍t ê lông-tō· 226 ppm chó-iū, ài ta̍k-kang sú-iōng.

Hu̍t-hòa-bu̍t tī-liâu ê hù-chok-iōng
------------------------------------

Tn̂g-kî koân lông-tō· ê fluoride khip-siu (chhiau-kòe 8 ppm) ē chō-sêng kut-thâu ê hu̍t-tiòng-to̍k (*skeletal fluorosis*), i-ê te̍k-cheng sī kut-thâu bi̍t-tō· chiáng-koân, iû-kî tī lêng-kut kap kut-phûn-kut, ham tn̂g-kut (*long bone*) kāu-tōa cheng-ka. Tī giâm-tiōng ê chêng-hêng chham jūn-tōa mā-ē hoat-seng kài-hòa. Hu̍t-tiòng-to̍k ê kut-thâu kiông-tō· piàn bài, tiāⁿ-tiāⁿ ē bô-tiuⁿ-tî kut-chek.

Kòe-liōng ê fluoride khip-siu mā-ē ín-khí chhùi-khí ê hu̍t-tiòng-to̍k (*dental fluorosis*), án-ne ē khòaⁿ-tio̍h chhùi-khí chhut-hiān pan-chōng-khí (*mottled tooth*) ê chêng-hêng, khah kheng-bî--ê sī chhùi-khí piáu-bīn ū pe̍h-pan, jiân-āu sī nā chiù-khang ê ka-pi-sek khám-khiat, siāng giâm-tiōng--ê sī kui-ki chhùi-khí ê hoat-io̍k-put-choân (*hypoplasia*). Fluoride ê khip-siu nā chhiau-kòe 2 p.p.m. tio̍h-ē hoat-seng pan-chōng-khí, in-ūi éng-kiú-khí ê mn̂g-khí kap kak-khí ê khí-koan tī 6-hòe chìn-chêng tio̍h hêng-sêng oân-choân, in-chhú 6-hòe chìn-chêng mài hō· gín-á tn̂g-kî thun-chia̍h kòe-liōng ê fluoride, tio̍h ē-tàng phiah-bián pan-chōng-khí ê hoat-seng. 

Ko·-1-kái thun-chia̍h kòe-liōng ê fluoride ē-tit ín-khí kip-sèng ê hu̍t-tiòng-to̍k, it-poaⁿ lâi-kóng, hō·-lí-sí ê che-liōng (*CLD*, *certainly lethal dose*) sī 32~64 mg/kg, an-choân jím-siu che-liōng (*STD*, safely tolerated dose) sī 8~16 mg/kg, khó-lêng tiòng-to̍k che-liōng (*PTD*, *probably toxic dose*) sī 5mg/kg. Kip-sèng hu̍t-tiòng-to̍k ê te̍k-cheng sī beh-thò·, áu-thò·, phak-tó·-thiàⁿ, làu-sái. Ūi-tio̍h phiah-bián gín-á hu̍t-tiòng-to̍k, 6-hòe í-āu chiah ē-tàng sú-iōng hâm-hu̍t lo̍k-chhùi-chúi, 2~6-hòe--ê sú-iōng hâm-hu̍t khí-ko mā-tio̍h-ài tī tōa-lâng ê kàm-tho̍k chi-hā chiah ē-sài--chit. Siat-sú bô-sió-sim thun-chia̍h hu̍t-hòa-bu̍t, ē-tit ēng gû-leng he̍k hâm aluminium/magnesium ê chè-sng-chē (ūi-io̍h) lâi kiám-chió hu̍t ê khip-siu, ah-nā tōa-liōng thun-chia̍h tio̍h-ài sûi sàng-khí pēⁿ-īⁿ chhui-thò· kap chìn-1-pō· chhú-lí.

  


**Chhùi-khiuⁿ pó-kiàn iōng-phín hâm-hu̍t-liōng kap kip-sèng hu̍t-tiòng-to̍k che-liōng ê pí-kàu (í 20 kong-kin ê gín-á chò-lē)**| Têng-tō· | 20 kong-kin ê gín-á kip-sèng tiòng-to̍k só· su-iàu ê chē-liōng | Sú-iōng 1000 ppm 200g ê khí-ko só· su-iàu ê sò·-liōng | Sú-iōng 0.2-pha NaF lo̍k-chhùi-chúi só· su-iàu ê sò·-liōng |
| --- | --- | --- | --- |
| Hō·-lí-sí che-liōng (CLD, 32~64 mg/kg) | 640~1,280 mg | 3.2~6.4 tiâu | 710~1,420 ml |
| An-choân jím-siū che-liōng (STD, 8~16 mg/kg) | 160~320 mg | 0.8~1.6 tiâu | 180~360 ml |
| Khó-lêng tiòng-to̍k che-liōng (PTD, 5 mg/kg) | 100 mg | pòaⁿ-tiâu | 111 ml |

Chham-khó chu-liāu
------------------

Siā-khu bîn-chiòng sú-iōng gê-kho hu̍t-hòa-bu̍t chí-ín chhiú-chheh (ōe-seng i-lâu jîn-goân pán), Tiong-hôa bîn-kok jî-tông gê-kho i-ha̍k-hōe pian-chè, 2005 nî 3--goe̍h.