Self-reported Evaluation of Psychosociaal Effects of Fluorosis among Inhabitants Living in a Rural Fluorosis Epidemic Area in China: Psychosocial Effects of Dental Fluorosis

Abstract

Objective: The purpose of this study was to investigate the psychosocial effects of fluorosis on the patients in the fluorosis epidemic area. Methods: In the rural fluorosis epidemic areas in Hebei province of China, 416 inhabitants were randomly selected to be examined using Dean's Index (DI). Surface Index of Fluorosis (TSIF) was used in 178 recruited participants who were also involved in a psychosocial questionnaire investigation. Demographic information and six five-point subscales about "Attitude to Teeth", "Index of Well-Being", "Index of General Affect", "Interaction Anxiousness Scale" (IAS), "Self-Esteem Scale" (SES) and "Impact on Behavior" were included in the questionnaire. SPSS12.0 software was used to analyze the data. Result: Fluorosis prevalence in the fluorosis epidemic areas of Hebei province was 71.2%, with 1.77 of Community Fluorosis Index. Prevalence of fluorosis according to DI was lower than the results of TSIF. Difference of fluorosis prevalence calculating by DI and TSIF was evident in 35-44 years old group, and the proportion of such questionable" cases in 35-44 age group was the highest, which was 40.3%. With the increase of DI score, the average values of subscale "Attitude to Teeth" (2.58-3.51) and "Index of Well-Being" (2.35-2.90) increased. Significant difference of the evaluation on "Attitude to Teeth" could only be found between the "mild group" (DI=1/2) and the "severe group" (DI=3/4), also between the "control group" (DI=0/0.5) and the "severe group". As for the evaluation scores on "Index of Well-Being", there was significantly different between the "control group" and the "severe group". According to the results of multivariate linear stepwise regression analysis, the independent variable entered the regression model was mainly the DI score, while the evaluation of other subscales were not significantly associated with the independent variables in this analysis.

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

“…” [ 49 , page 37] This implies that while nonwater sources of fluoride are likely to be consumed at the same level in fluoridated and nonfluoridated areas, and while the use of dental supplements is higher in nonfluoridated areas, fluorosis is significantly higher in areas where water is fluoridated. While the only uncontroversial clinical complication of (severe) dental fluorosis is adverse psychological impact on well-being, self-esteem, and negative community perception of affected individuals' oral health [ 61 ], established clinical complications of skeletal fluorosis include arthritis, radiculomyelopathy, quadriparesis, and pathological bone fractures [ 62 , 63 ].…”

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

“…” [ 49 , page 37] This implies that while nonwater sources of fluoride are likely to be consumed at the same level in fluoridated and nonfluoridated areas, and while the use of dental supplements is higher in nonfluoridated areas, fluorosis is significantly higher in areas where water is fluoridated. While the only uncontroversial clinical complication of (severe) dental fluorosis is adverse psychological impact on well-being, self-esteem, and negative community perception of affected individuals' oral health [ 61 ], established clinical complications of skeletal fluorosis include arthritis, radiculomyelopathy, quadriparesis, and pathological bone fractures [ 62 , 63 ].…”

A Review of Fluoride Removal From Ground Water by Various Adsorption Techniques

“…The brown streaks may turn black and affect the whole tooth which may get pitted, perforated and chipped off at the final stage. Dental fluorosis not only poses cosmetic problems but has also serious aspects too, in terms of matrimonial issues 23 .…”

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

“…” [ 49 , page 37] This implies that while nonwater sources of fluoride are likely to be consumed at the same level in fluoridated and nonfluoridated areas, and while the use of dental supplements is higher in nonfluoridated areas, fluorosis is significantly higher in areas where water is fluoridated. While the only uncontroversial clinical complication of (severe) dental fluorosis is adverse psychological impact on well-being, self-esteem, and negative community perception of affected individuals' oral health [ 61 ], established clinical complications of skeletal fluorosis include arthritis, radiculomyelopathy, quadriparesis, and pathological bone fractures [ 62 , 63 ].…”

A Review of Fluoride Removal From Ground Water by Various Adsorption Techniques

“…The brown streaks may turn black and affect the whole tooth which may get pitted, perforated and chipped off at the final stage. Dental fluorosis not only poses cosmetic problems but has also serious aspects too, in terms of matrimonial issues 23 .…”

Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention

“…” [ 49 , page 37] This implies that while nonwater sources of fluoride are likely to be consumed at the same level in fluoridated and nonfluoridated areas, and while the use of dental supplements is higher in nonfluoridated areas, fluorosis is significantly higher in areas where water is fluoridated. While the only uncontroversial clinical complication of (severe) dental fluorosis is adverse psychological impact on well-being, self-esteem, and negative community perception of affected individuals' oral health [ 61 ], established clinical complications of skeletal fluorosis include arthritis, radiculomyelopathy, quadriparesis, and pathological bone fractures [ 62 , 63 ].…”

A Review of Fluoride Removal From Ground Water by Various Adsorption Techniques

“…The brown streaks may turn black and affect the whole tooth which may get pitted, perforated and chipped off at the final stage. Dental fluorosis not only poses cosmetic problems but has also serious aspects too, in terms of matrimonial issues 23 .…”