Race (black-white) and sex inequalities in tooth loss: A population-based study

Lívia Helena Terra E Souza; Fredi Alexander Diaz-Quijano; Marilisa Berti de Azevedo Barros; Margareth Guimarães Lima

doi:10.1371/journal.pone.0276103

Race (black-white) and sex inequalities in tooth loss: A population-based study

PLoS One. 2022 Oct 13;17(10):e0276103. doi: 10.1371/journal.pone.0276103. eCollection 2022.

Authors

Lívia Helena Terra E Souza¹, Fredi Alexander Diaz-Quijano², Marilisa Berti de Azevedo Barros¹, Margareth Guimarães Lima¹

Affiliations

¹ Department of Collective Health, Collaborating Center for Health Situation Analysis (CCAS), School of Medical Science, University of Campinas, Campinas, São Paulo, Brazil.
² Department of Epidemiology, Laboratory of Causal Inference in Epidemiology [Laboratório de Inferência Causal em Epidemiologia], School of Public Health, University of São Paulo, São Paulo, Brazil.

Abstract

The effect of health inequalities is determined by different socioeconomic, sex, and race conditions. This study aimed to analyze the association of tooth loss with race (defined by self-reported skin color) and sex. Based on the hypothesis that the association between tooth loss and race may be modified by sex, we also aimed to evaluate possible interactions between race and sex in association with this event, in a population-based study in the city of Campinas, Brazil. A directed acyclic graph was used to select covariates. The prevalence, of tooth loss was 19% higher in black women compared to white men (Prevalence ratio [PR]: 1.19; 95%CI: 1.05-1.34). Moreover, the prevalence of tooth loss in black women was 26% higher than in white women (PR: 1.26; 95%CI: 1.13-1.42); and, within the strata of black people, black women had 14% higher dental loss (PR: 1.14; 95%CI: 1.02-1.27) compared to black men. This study found a significant interaction between race and sex in tooth loss, with a disadvantage for black women. In addition, this work contributes to the discussion of health inequities and can support policies for the provision of universal dental care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Black People
Brazil / epidemiology
Female
Humans
Male
Prevalence
Self Report
Skin Pigmentation
Socioeconomic Factors
Tooth Loss* / epidemiology

Grants and funding

Funding information: FADQ is beneficiary of a fellowship for research productivity from the National Council for Scientific and Technological Development - CNPq, process/contract identification: 312656/2019-0. The National Council of Technological and Scientific Development (CNPq) funded the research (Grant number: 309073/2015-4) and funds the productivity scholarship granted to MBAB. The survey was supported by the State of São Paulo Research Assistance Foundation (FAPESP) (Process number: 2012/23324-3), Ministry of Health and the Secretary of Health of Campinas (Partnership UNICAMP/Funcamp/SMS 136/14). Funders had no role at any stage in the conduct of the manuscript. These authors contributed equally to this work.