Color/race inequalities in oral health among Brazilian adolescents

Abstract

This study assessed oral health outcomes (perceived dental treatment need, untreated dental caries, gingival bleeding, periodontal pockets, and pain in teeth and gums), in relation to color/race inequalities among adolescents in each Brazilian region. The database included dental examination and interview of 16,833 15-19-year-old adolescents, surveyed by the Brazilian health authority, from May 2002 to October 2003, in accordance with international diagnostic criteria standardized by the World Health Organization. Prevalence ratios estimated by Poisson regression, and controlled by socioeconomic status and access to fluoridated piped water, assessed oral health differentials among color/race groups and country's regions. Except for periodontal pockets, prevalence figures were higher in the North and Northeast: perceived dental treatment needs, untreated dental caries, gingival bleeding at probing and pain in teeth and gums varied between 80-83%, 75-76%, 38-43%, and 17-18%, respectively, in these regions. Adolescents living in the Southeast - the richest Brazilian region - presented a better general profile of oral health than their counterparts living in the remaining regions; they had a lower prevalence of untreated dental caries (54%) and unfavorable gingival status (29%). However, the Southeast presented color/race inequalities in all oral health outcomes, with a poorer profile systematically affecting browns or blacks, depending on the oral health condition under consideration. These results reinforce the need for expanding the amplitude of health initiatives aimed at adolescent oral health. Socially appropriate health programs should concurrently aim at the reduction of levels of oral disease and its inequalities.

The role of potential mediators in racial inequalities in tooth loss: the Pró‐Saúde study

“…In the present study, there was a residual association between race and tooth loss, which was not explained by postulated confounding factors and mediators. Some authors suggest that this residual effect may be related to nonperceived racial discrimination (6,9,10,15). Other explanations include residual confounding by socioeconomic status and that our discrimination measure did not thoroughly assess the experiences of discrimination in the domain of health care.…”

Caries Is the Main Cause for Dental Pain in Childhood: Findings from a Birth Cohort

“…This could result from the residual confusion of a variable not investigated. These differences could also be related to the inequity in access to services, such as exposure to fluoridated water and regular use of fluoride toothpaste, or the difference could be related to discrimination or the way individuals feel and express pain [Antunes et al, 2006;Bastos et al, 2008Bastos et al, , 2009. Therefore, new investigations are required to understand these differences.…”

Determinantes individuais e contextuais da cárie em crianças brasileiras de 12 anos em 2010

“…Specifi cally dealing with the prevalence of untreated dental caries in Brazilian adolescents, Bastos et al 4 (2009) reported higher levels of the disease in groups with black and brown skin compared with those with white skin.…”