Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Community Dent Oral Epidemiol. 2013 Dec;41(6):509-16. doi: 10.1111/cdoe.12051. Epub 2013 May 6.
To assess the relation between race and tooth loss, as well as the influence of socioeconomic factors, health behaviours, routine dental care and self-reported discrimination on this association.
This is a cross-sectional study with data collected from the baseline of the Pró-Saúde Study (Rio de Janeiro/Brazil), among 3253 civil servants in 1999-2001. Race was measured as self-reported skin colour (Black/Brown/White). The outcome was self-reported tooth loss, measured in four ordered categories (none/one or few/many/all or almost all). Three mediating pathways were explored between race and tooth loss. The first included self-reported discrimination assessed with a five-item scale. The second pathway included behavioural factors: routine dental care, marital status, smoking and alcohol consumption. The third considered socioeconomic factors: income, education, maternal education and early life poverty. Confounding factors were age and sex. Statistical analyses were carried out with ordinal logistic regression.
Absence of all or almost all teeth was reported by 8% of respondents. White individuals comprised 53% of the population, followed by Browns (26%) and Blacks (22%). After adjustment, Blacks had an odds ratio of being in a higher category of missing teeth equal to 1.39 (95% CI 1.12-1.72), and Browns, 1.33 (95% CI 1.10-1.60), when compared to Whites. Age, sex and socioeconomic variables explained most of racial inequalities in tooth loss, while behavioural and discrimination variables contributed very little. Behavioural and socioeconomic variables were associated with tooth loss, while discrimination was not. No statistically significant interactions were found.
There is an association between race and tooth loss that is mainly explained by current and early life socioeconomic variables, but not by behavioural factors and self-reported discrimination.
评估种族与牙齿缺失之间的关系，以及社会经济因素、健康行为、常规牙科护理和自我报告的歧视对这种关联的影响。
这是一项横断面研究，数据来自 1999-2001 年 Pro-Saúde 研究（巴西里约热内卢）的基线，共纳入 3253 名公务员。种族通过自我报告的肤色（黑/棕/白）来衡量。结果是自我报告的牙齿缺失，用四个有序类别（无/一个或几个/多个/全部或几乎全部）来衡量。探索了种族和牙齿缺失之间的三种中介途径。第一种途径包括使用五分量表评估的自我报告的歧视。第二种途径包括行为因素：常规牙科护理、婚姻状况、吸烟和饮酒。第三种途径考虑了社会经济因素：收入、教育、母亲教育和早年贫困。混杂因素为年龄和性别。采用有序逻辑回归进行统计分析。
8%的受访者报告没有或几乎没有所有牙齿。白人占人口的 53%，其次是棕色人种（26%）和黑人（22%）。调整后，与白人相比，黑人缺失牙齿的较高类别比值比为 1.39（95%CI 1.12-1.72），棕色人种为 1.33（95%CI 1.10-1.60）。年龄、性别和社会经济变量解释了牙齿缺失的大部分种族不平等，而行为和歧视变量的贡献很小。行为和社会经济变量与牙齿缺失相关，而歧视则没有。未发现统计学上显著的交互作用。
种族与牙齿缺失之间存在关联，这种关联主要由当前和早年的社会经济变量解释，但不是由行为因素和自我报告的歧视解释。
