Objective To analyze the association between dental fluorosis and mental health of middle school students in an endemic area of coal burning induced fluorosis, and to provide reference for making strategies for mental counseling.
Methods A total of 2 385 junior and senior high school students in Gulin County were chosen by stratified cluster random sampling method to receive clinical diagnosis (dental fluorosis, normal, and suspect) and self-evaluation (dental fluorosis, normal, and unknown). The students also completed a questionnaire using Mental Health Inventory of Middle-School Students (MMHI-60).
Results The positive rate of dental fluorosis in the selected middle school students was 59.8% according to clinical diagnosis and 11.9% according to self-evaluation, indicating a low consistency (Kappa=0.141, P< 0.001). Based on the clinical diagnosis results, the differences in the total score and each dimension's score of mental health were not significant among the three groups (P> 0.05). Based on self-evaluation results, the differences in the total score and each dimension's score, except for academic pressure, were significant among the three groups (P< 0.05).
Conclusion Self-evaluation on dental fluorosis among middle school students reveals an association with mental health (except for academic pressure). The local government should include early health education programs of fluorosis into agenda and pay attention to possible mental effects in education programs on dental fluorosis.
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