OBJECTIVETo explore the psychosocial effect of fluorosis on patients in fluorosis epidemic areas.

METHODSMultistage, stratified, clustered and random sampling method was used in this survey. Totally 416 inhabitants of 12, 15 and 35-44 years of age from rural fluorosis epidemic areas in Hebei province were selected. Dental fluorosis was classified by Dean's index (DI). A total of 178 patients with different types of fluorosis were involved in a psychosocial questionnaire investigation which included six five-point subscales, including attitude to teeth, subjective well-being, life satisfaction, interpersonal or social anxiety, effect of self-esteem, impact on behavior.

RESULTSFluorosis prevalence in fluorosis epidemic areas of Xingtai in Hebei province was 71.20%, and significant difference existed among three age groups (Pearson Chi-square value = 167.51, P < 0.01). With the increase of DI score, the average value of subscale "attitude to teeth" rising, ranging from 2.58 to 3.51, and value of "subjective well-being" was also increasing, ranging from 2.35 to 2.9. Statistical difference of subscale average value was found only in these two subscales ("attitude to teeth": F = 4.787, P < 0.01; "subjective well-being": F = 2.538, P < 0.05). "Attitude to teeth" was significantly different between control group and moderate group (F = 0.52, P < 0.01) and between control group and severe group (F = 0.72, P < 0.01). While significant difference of "subjective well-being" could only be found between control group and severe group (F = 0.56, P < 0.01). According to the bivariate correlation analysis, strong correlation could be found between the degree of fluorosis and the average value of sub-scales.

CONCLUSIONSThe psychosocial impact of fluorosis on patients in fluorosis epidemic areas mainly appeared in two aspects, i.e. attitude to teeth and the perception of well-being, especially in severe group.