Federal University of Pelotas, 457, Gonçalves Chaves St. 5th floor, Pelotas, Rio Grande do Sul, 96015-560, Brazil.
Department of Dentistry, Federal University of Sergipe, Cláudio Batista St., Aracaju, 49060-108, Brazil.
Clin Oral Investig. 2019 Mar;23(3):1023-1030. doi: 10.1007/s00784-018-2526-7. Epub 2018 Jun 23.
To investigate whether patients' skin color could exert an influence on the dentist's decision-making for treatment, in four different cities in Brazil.
Lists of dentists were obtained and the sample selection was performed systematically. Two questionnaires were produced for the same clinical case, but the images were digitally manipulated to obtain a patient with a black and a white skin color. Dentists were free to choose treatment without any restrictions, including the financial aspects. A random sequence (white or black) was generated which was placed at random in sealed, opaque envelopes. Dentists were questioned about the decision on the treatment of a severely decayed tooth and an ill-adapted amalgam restoration.
A total of 636 dentists agreed to participate in the study. After adjustments (multinomial logistic regression), it was observed that the black patient with a decayed tooth had a 50% lower risk of being referred for prosthetic treatment (p = 0.023) and a 99% higher risk of receiving a composite resin restoration, compared to the white patient (p = 0.027). No differences were observed regarding recommendation for tooth extraction (p = 0.657). In relation to an ill-adapted amalgam, the black patient had less risk of receiving a referral replacement with composite resin (0.09 95%CI [0.01-0.82]) and finishing and polishing (0.11 5%CI [0.01-0.99]) compared with the white patient.
Patient skin color influenced the dentist's choice of treatment. In general, black patients receive referrals for cheaper, simpler procedures.
Skin color played an important role in dentists' treatment decisions. Professionals may contribute unconsciously to the propagation and replication of racial discrimination.
在巴西四个城市研究患者肤色是否会影响牙医的治疗决策。
获取牙医名单并进行系统抽样。为相同的临床病例制作了两份问卷，但通过数字处理改变了图像，使患者肤色为黑色和白色。牙医可以自由选择治疗方案，不受任何限制，包括经济方面。生成一个随机序列（白色或黑色），并将其放置在密封、不透明的信封中随机排列。牙医被问到关于严重龋齿和不适应的银汞合金修复体的治疗决策。
共有 636 名牙医同意参与研究。经过调整（多项逻辑回归）后，观察到患有龋齿的黑人患者接受修复治疗的可能性降低了 50%（p=0.023），而接受复合树脂修复的可能性增加了 99%（p=0.027），而白色患者则没有差异。对于拔牙建议（p=0.657），未观察到差异。对于不适应的银汞合金，黑人患者接受复合树脂更换修复的可能性降低（0.09 95%CI [0.01-0.82]）和完成和抛光（0.11 5%CI [0.01-0.99]）的可能性降低，与白色患者相比。
患者肤色影响牙医的治疗选择。总体而言，黑人患者接受更便宜、更简单的治疗方案。
肤色在牙医的治疗决策中起着重要作用。专业人员可能会无意识地助长种族歧视的传播和复制。
