Soares G H, Sethi S, Jessani A, Jamieson L
Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia.
Schulich School of Medicine and Dentistry, Western University, London, Canada.
J Dent Res. 2025 May;104(5):495-502. doi: 10.1177/00220345241310223. Epub 2025 Feb 14.
This study investigated whether sex assigned at birth and sexuality have a moderating role on the effect of discrimination on oral health impacts among adolescents. Using data from the Longitudinal Study of Australian Children, a sample representative of all Australian adolescents aged 14 to 15 y ( = 2,905), we employed propensity score overlap weights to achieve covariate balance between participants exposed and unexposed to discrimination. Various forms of discrimination were examined: due to cultural background, due to mental health condition, due to sexual orientation, and due to sex assigned at birth. Oral health impact was assessed using the PedsQ Oral Health Scale. Poisson regression with robust variance was conducted including sex, sexual attraction, and discrimination as interaction terms. The sample included 1,407 females (49%) and 336 lesbian, gay, bisexual, and questioning (LGBQ) individuals (11%). More than 22% experienced at least 1 form of discrimination in the previous 6 mo. Findings from the overlap weighting analysis revealed that, in general, females had higher proportions of oral health impact compared with males, whereas sexually diverse youth tended to have worse oral health outcomes compared with non-LGBQ youth. A 2-fold higher prevalence rate of oral health impacts was found for sexually diverse females exposed to discrimination due to cultural background (95% confidence interval [CI]: 1.36-2.44) and due to mental health conditions (95% CI: 1.62-2.46). The largest effects of discrimination on oral health impacts were consistently observed among sexually diverse females. This novel study provides evidence on the moderating role of sex and sexuality in the relationship between discrimination and oral health among adolescents.
本研究调查了出生时被指定的性别和性取向在歧视对青少年口腔健康影响的作用中是否具有调节作用。利用澳大利亚儿童纵向研究的数据，该样本代表了所有14至15岁的澳大利亚青少年（ = 2905），我们采用倾向得分重叠权重来实现暴露于和未暴露于歧视的参与者之间的协变量平衡。研究考察了各种形式的歧视：因文化背景、因心理健康状况、因性取向以及因出生时被指定的性别。使用儿童口腔健康量表评估口腔健康影响。进行了稳健方差的泊松回归，将性别、性吸引力和歧视作为交互项纳入。样本包括1407名女性（49%）和336名女同性恋、男同性恋、双性恋和性取向存疑（LGBQ）个体（11%）。超过22%的人在过去6个月中经历了至少一种形式的歧视。重叠加权分析的结果显示，总体而言，与男性相比，女性口腔健康影响的比例更高，而与非LGBQ青年相比，性取向多元的青年往往有更差的口腔健康结果。对于因文化背景（95%置信区间[CI]：1.36 - 2.44）和因心理健康状况（95% CI：1.62 - 2.46）而遭受歧视的性取向多元女性，发现其口腔健康影响的患病率高出两倍。在性取向多元的女性中，始终观察到歧视对口腔健康影响的最大效应。这项新颖的研究提供了关于性别和性取向在青少年歧视与口腔健康关系中的调节作用的证据。
