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Karam SA, Schuch HS, Demarco FF, Horta BL, Borrell LN, Celeste RK, Correa MB. Differential effect of social mobility on tooth loss by race in adulthood: 1982 Pelotas Birth Cohort Study. Community Dent Oral Epidemiol 2024. [PMID: 38778564 DOI: 10.1111/cdoe.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/20/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To examine the association between social mobility and tooth loss in adults from the 1982 Pelotas Birth Cohort Study and whether race modifies this association. METHODS The Oral Health Study used data from 541 individuals who were followed up to 31 years of age. Social mobility, composed of the participants' socioeconomic position (SEP) at birth and at age 30, was categorized as never poor, upwardly mobile, downwardly mobile and always poor. The outcome was the prevalence of at least one tooth lost due to dental caries when the participants were examined at 31 years of age. The effect modifier was race (Black/Brown versus white people). Log-binomial regression models were used to estimate crude and sex-adjusted prevalence ratios (PR) and to determine whether the association varied with race. Statistical interactions were tested using an additive scale. RESULTS The prevalence of any tooth loss was 50.8% (n = 274). In social mobility groups, the prevalence of at least one tooth lost in the never-poor group was about 31% points higher for Black/Brown (68.2%) than for white people (37.4%). Antagonistic findings were found for the interaction between race and social mobility (Sinergy Index = 0.48; 95% CI 0.24, 0.99; and relative excess of risk due to the interaction = -1.38; 95% CI -2.34, -0.42), suggesting that the observed joint effect of race and social mobility on tooth loss was lower than the expected sum of these factors. The estimates for Black/Brown people were smaller for those who were always poor during their lives, relative to their white counterparts. CONCLUSIONS The findings suggest a higher prevalence of at least one tooth lost among people in the downward mobile SEP group and Black/Brown people. Greater racial inequity was found among Black/Brown people who had never experienced episodes of poverty, with Black/Brown people having a greater prevalence of at least one tooth lost than their white counterparts.
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Affiliation(s)
- Sarah Arangurem Karam
- Graduate Program in Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
- Professional Master's in Health in the Life Cycle, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Bernardo L Horta
- Graduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luisa N Borrell
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York, USA
| | - Roger Keller Celeste
- Graduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Pires ALC, Costa FDS, D'Ávila OP, Carvalho RVD, Conde MCM, Correa MB, Demarco FF, Chisini LA. Contextual inequalities in specialized dental public health care in Brazil. Braz Oral Res 2024; 38:e023. [PMID: 38597543 DOI: 10.1590/1807-3107bor-2024.vol38.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 06/15/2023] [Indexed: 04/11/2024] Open
Abstract
The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.
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Affiliation(s)
- Ana Luiza Cardoso Pires
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | | | - Otávio Pereira D'Ávila
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Social Dentistry, Pelotas, RS, Brazil
| | | | - Marcus Cristian Muniz Conde
- Universidade do Vale do Taquari-Univates, Center for Biological Sciences and Health, Department of Restorative Dentistry, Lajeado, RS, Brazil
| | - Marcos Britto Correa
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | - Flávio Fernando Demarco
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
| | - Luiz Alexandre Chisini
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
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Chisini LA, Dos Santos Costa F, Salvi LC, Poletto Neto V, Varella de Carvalho R, Demarco FF. Is the effect of COVID-19 on periodontal treatment similar to that in general dental care and primary medical care? an observational study in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:609-618. [PMID: 35286215 DOI: 10.1080/09603123.2022.2043250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The present study aimed to analyze the effect of the COVID-19 pandemic on the rates of periodontal procedures, and provide a comparison with general dental care and primary medical care procedures carried out in the Brazilian Public Health System. The study had an ecological, retrospective design with data from 5,564 Brazilian municipalities (99.9%). A multilevel mixed-effects linear regression was used to analyze the longitudinal associations between the COVID-19 pandemic and the rate of procedures. There was a significant reduction in the number of periodontal procedures (Coef. -428.6 [95%CI -774.3/-82.9]) during the COVID-19 pandemic, although this reduction was no greater than that of medical and general dental procedures. Medical procedures witnessed the sharpest drop in procedures (Coef. -2831.5 [95%CI -3964.1/-1699.0]). A lower rate of general dental procedures was also identified during the pandemic (Coef. -2,110.6 [95%CI -3,400.8/-820.4]). The COVID-19 pandemic has had a negative effect on the rate of periodontal procedures carried out in the Brazilian Public Health System. The highest recutions were observed in general dental and medical procedures.
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Affiliation(s)
- Luiz Alexandre Chisini
- Institute of Health Sciences, Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Francine Dos Santos Costa
- Center of Biological Sciences and Health, Department of paediatric dentistry, University of Vale do Taquari, Lajeado, Brazil
| | - Luana Carla Salvi
- Center of Biological Sciences and Health, Department of Biology, University of Vale do Taquari, Lajeado, Brazil
| | - Victório Poletto Neto
- Institute of Health Sciences, Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Rodrigo Varella de Carvalho
- Institute of Health Sciences, Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, Brazil
| | - Flávio Fernando Demarco
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Cortez GFP, Barbosa GZ, Tôrres LHDN, Unfer B. Reasons for and consequences of tooth loss in adults and elderly people in Brazil: a qualitative metasynthesis. CIENCIA & SAUDE COLETIVA 2023; 28:1413-1424. [PMID: 37194875 DOI: 10.1590/1413-81232023285.01632022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/18/2022] [Indexed: 05/18/2023] Open
Abstract
The objective was to analyze and systematize evidence reported in qualitative studies on the reasons and consequences of tooth loss in adults and elderly people in Brazil. A systematic review of the literature on qualitative research methods and a meta synthesis of the results were performed. The study population consisted of adults over 18 years of age and elderly people in Brazil. Searches were performed in the BVS, PubMed, Scopus, Web of Science, BBO, Embase, EBSCO and SciELO databases. The thematic synthesis identified 8 analytical themes regarding reasons for tooth loss and 3 analytical themes regarding consequences of tooth loss. Dental pain, care model, financial situation and desire for prosthetic rehabilitation were determining factors for extractions. There was recognition of negligence in oral care, and the naturalness of tooth loss was linked to old age. Missing teeth caused psychological and physiological impacts. It is imperative to verify whether the factors that cause tooth loss persist, and how much those factors influence decisions to extract teeth among current young and adult populations. It is necessary to change the care model through the inclusion and qualification of oral health care for the young and elderly adult populations; otherwise, the model of dental mutilation and the culture of edentulism will persist.
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Affiliation(s)
| | | | | | - Beatriz Unfer
- Universidade Federal de Santa Maria. Santa Maria RS Brasil
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Chisini LA, Santos FDC, de Carvalho RV, Horta BL, Tovo-Rodrigues L, Demarco FF, Correa MB. Impact of tooth mineral tissues genes on dental caries: a birth-cohort study. J Dent 2023; 133:104505. [PMID: 37031884 DOI: 10.1016/j.jdent.2023.104505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVE We aimed to investigate whether Single Nucleotide Polymorphisms present in the genes of tooth mineral tissues influence dental caries trajectory across the life course, and if there is an epistatic (gene-gene) interaction between these SNPs. METHODS A representative sample of all 5,914 births from the 1982 Pelotas birth cohort study was prospectively investigated. Dental caries trajectory across the life course was assessed at 15(n=888), 24(n=720), and 31 years old(n=539). Group-based trajectory modelling was used to identify distinct subgroups of individuals whose caries measurements followed a similar pattern over time. Genetic material was collected, and individuals were genotyped [rs4970957(TUFT1), rs1711437(MMP20), rs1784418(MMP20), rs2252070(MMP13), rs243847(MMP2), rs2303466(DLX3), rs11656951(DLX3), rs7501477(TIMP2), rs388286(BMP7), and rs5997096(TFIP11)]. Analyzes were performed for allele and genotype using logistic regression and generalized multifactor dimensionality reduction for epistatic interactions. RESULTS The analyses included 678 individuals, those with allele C (OR=0.74, CI95%[0.59-0.92]), genotype CC in the additive effect (OR=0.52, CI95%[0.31-0.89]), and the genotype TC/CC in dominant effect (OR=0.72, CI95%[0.53-0.98]) on the rs243847(MMP2) were associated with low caries trajectory. Individuals with the allele T (OR=0.79, CI95%[0.64-0.98]) and the genotype TC/CC in dominant effect (OR=0.66, CI95%[0.47-0.95]) on the rs5997096(TFIP11) were associated with low caries trajectory. Positive epistatic interactions were observed involving two (MMP2 and BMP7; p=0.006) and three (TUFT1, MMP2, and TFIP11; p<0.001) loci and high caries trajectory. CONCLUSIONS Some SNPs present in the genes of tooth mineral tissues were associated with caries trajectory and epistatic interactions increasing the network of SNPs involved in individual caries experience. CLINICAL SIGNIFICANCE Single nucleotide polymorphisms in the pathway of tooth mineral tissues genes may contribute significantly to the individual caries experience across the life course.
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Affiliation(s)
- Luiz Alexandre Chisini
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Address: 457, Gonçalves Chaves St. 5th floor, Pelotas, Brazil 96015-560.
| | - Francine da Costa Santos
- Graduate Program in Epidemiology, Federal University Pelotas, Address: 1160, Marechal Deodoro St. Pelotas, RS, Brazil 96020-220.
| | - Rodrigo Varella de Carvalho
- Graduate Program in Dentistry, Federal University of Juiz de Fora, Governador Valadares, MG, Brazil. Address: 745, São Paulo St., Governador Valadares, Brazil 35010-180.
| | - Bernardo Lessa Horta
- Post Graduate Program in Epidemiology, Federal University Pelotas, Address: 1160, Marechal Deodoro St. Pelotas, RS Brazil 96020-220.
| | - Luciana Tovo-Rodrigues
- PhD, Graduate Program in Epidemiology, Federal University Pelotas, Address: 1160, Marechal Deodoro St. Pelotas, RS, Brazil 96020-220.
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Address: 457, Gonçalves Chaves St. 5th floor, Pelotas, Brazil 96015-560.
| | - Marcos Britto Correa
- DDS, MSc, PhD. Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Address: 457, Gonçalves Chaves St. 5th floor, Pelotas, Brazil 96015-560.
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Chisini LA, Varella de Carvalho R, Dos Santos Costa F, Salvi LC, Demarco FF, Britto Correa M. Genes and single nucleotide polymorphisms in the pathway of saliva and dental caries: a systematic review and meta-analysis. BIOFOULING 2023; 39:8-23. [PMID: 36644905 DOI: 10.1080/08927014.2022.2162891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/01/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
The aim of this systematic review and meta-analysis was to investigate the influence of single nucleotide polymorphisms (SNPs), related to genes in salivary composition and flow, on dental caries experience. Sixteen studies were included in the systematic review and ten in the meta-analysis. Forty-four SNPS, covering four genes (CA6, AQP2, AQP5, and MUC5B) were identified. Most of the SNPs were not associated with caries in meta-analysis. Homozygous TT genotype of the SNP CA6 rs17032907(C/T) was associated with caries [OR = 3.23(1.39-7.49)]. The pool effect of the SNPs assessed in AQP5 was associated with a reduction in the likelihood of caries [OR = 0.75(0.59-0.95)]. Considering all SNPs of salivary composition and flow, the effect allele was associated with a 75% increase in the likelihood of caries [OR = 1.75(1.06-2.89)] in the homozygous genotype. The present findings showed that the genes in salivary composition and flow can play an important role in dental caries experience.
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Affiliation(s)
- Luiz Alexandre Chisini
- Graduate Program in Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | - Rodrigo Varella de Carvalho
- Graduate Program in Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil
| | | | - Luana Carla Salvi
- Graduate Program in Biology, University of Vale do Taquari, Rio Grande do Sul, Brazil
| | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Marcos Britto Correa
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Costa CA, Vilela ACS, Oliveira SA, Gomes TD, Andrade AAC, Leles CR, Costa NL. Poor oral health status and adverse COVID-19 outcomes: A preliminary study in hospitalized patients. J Periodontol 2022; 93:1889-1901. [PMID: 35294780 PMCID: PMC9088593 DOI: 10.1002/jper.21-0624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Most of the common risk factors for severe outcomes of coronavirus disease 2019 (COVID-19) are correlated with poor oral health, tooth loss, and periodontitis. This has pointed to a possible relationship between oral and systemic health in COVID-19 patients. Hence, this study aimed to assess the dental and periodontal status of hospitalized COVID-19 patients and their associations with the incidence of adverse COVID-19 outcomes. METHODS We included 128 hospital patients aged between 20 and 97 years and with diagnoses of COVID-19 in this prospective observational study. Dental and periodontal status was assessed using in-hospital clinical examinations, including the Decayed, Missing, and Filled Teeth index, periodontal status, and tooth loss patterns (Eichner index). Associations between oral health measures, the severity of COVID-19 symptoms, and hospitalization endpoints were tested using chi-square test and incidence rate ratio (IRR) estimation using a generalized linear model with log-Poisson regression. The regression models used a block-wise selection of predictors for oral health-related variables, comorbidities, and patients' ages. RESULTS Overall, poor oral health conditions were highly prevalent and associated with critical COVID-19 symptoms, higher risk for admission in the intensive care unit (ICU), and death. Periodontitis was significantly associated with ICU admission (IRR = 1.44; 95% confidence interval [95%CI] = 1.07-1.95; P = 0.017), critical symptoms (IRR = 2.56; 95%CI = 1.44-4.55; P = 0.001), and risk of death (IRR = 2.05; 95%CI = 1.12-3.76; P = 0.020) when adjusted for age and comorbidities. The Eichner index (classes B and C) was associated with ICU admission. CONCLUSION There was a positive association between deleterious oral health-related conditions, especially periodontitis, and severe COVID-19 outcomes in hospitalized COVID-19 patients.
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Affiliation(s)
- Camila Alves Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | - Suzane Aparecida Oliveira
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | | | | | - Cláudio Rodrigues Leles
- Department of Oral RehabilitationSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
| | - Nádia Lago Costa
- Center for Research in Oral Systemic HealthSchool of DentistryFederal University of GoiásGoianiaGoiásBrazil
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Saleeva L, Kashapov R, Shakirzyanov F, Kuznetsov E, Kashapov L, Smirnova V, Kashapov N, Saleeva G, Sachenkov O, Saleev R. The Effect of Surface Processing on the Shear Strength of Cobalt-Chromium Dental Alloy and Ceramics. MATERIALS 2022; 15:ma15092987. [PMID: 35591320 PMCID: PMC9103724 DOI: 10.3390/ma15092987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023]
Abstract
Porcelain fused to metal is widespread dental prosthetic restoration. The survival rate of metal-ceramic restorations depends not only on the qualifications of dentists, dental technicians but also on the adhesive strength of ceramics to a metal frame. The goal of the research is to determine the optimal parameters of the surface machining of the metal frame to increase the adhesion of metal to ceramics. Adhesion of cobalt-chromium alloy and ceramics was investigated. A profilometer and a scanning electron microscope were used to analyze the morphology. To estimate the adhesion the shear strength was measured by the method based on ASTM D1002-10. A method of surface microrelief formation of metal samples by plasma-electrolyte treatment has been developed. Regimes for plasma-electrolyte surface treatment were investigated according to current-voltage characteristics and a surface roughness parameter. The samples were subjected to different surface machining techniques such as polishing, milling, sandblasting (so-called traditional methods), and plasma-electrolyte processing. Morphology of the surface for all samples was studied and the difference in microrelief was shown. The roughness and adhesive strength were measured for samples either. As a result, the mode for plasma- electrolytic surface treatment under which the adhesive strength was increased up to 183% (compared with the traditional methods) was found.
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Affiliation(s)
- Liaisan Saleeva
- Kazan State Medical University, 420012 Kazan, Russia; (L.S.); (E.K.); (G.S.); (R.S.)
| | - Ramil Kashapov
- Joint Institute for High Temperatures of the Russian Academy of Science, 125412 Moscow, Russia; (R.K.); (L.K.); (N.K.)
- Institute of Engineering, Kazan Federal University, 420008 Kazan, Russia
| | - Farid Shakirzyanov
- Kazan State University of Architecture and Engineering, 420043 Kazan, Russia;
| | - Eduard Kuznetsov
- Kazan State Medical University, 420012 Kazan, Russia; (L.S.); (E.K.); (G.S.); (R.S.)
| | - Lenar Kashapov
- Joint Institute for High Temperatures of the Russian Academy of Science, 125412 Moscow, Russia; (R.K.); (L.K.); (N.K.)
- Institute of Engineering, Kazan Federal University, 420008 Kazan, Russia
| | - Viktoriya Smirnova
- N.I. Lobachevsky Institute of Mathematics, Kazan Federal University, 420008 Kazan, Russia;
| | - Nail Kashapov
- Joint Institute for High Temperatures of the Russian Academy of Science, 125412 Moscow, Russia; (R.K.); (L.K.); (N.K.)
- Institute of Engineering, Kazan Federal University, 420008 Kazan, Russia
| | - Gulshat Saleeva
- Kazan State Medical University, 420012 Kazan, Russia; (L.S.); (E.K.); (G.S.); (R.S.)
| | - Oskar Sachenkov
- N.I. Lobachevsky Institute of Mathematics, Kazan Federal University, 420008 Kazan, Russia;
- Correspondence:
| | - Rinat Saleev
- Kazan State Medical University, 420012 Kazan, Russia; (L.S.); (E.K.); (G.S.); (R.S.)
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Karam SA, Schuch HS, Demarco FF, Barros FC, Horta BL, Correa MB. Social and racial inequity in self-rated oral health in adults in Southern Brazil. CAD SAUDE PUBLICA 2022; 38:e00136921. [DOI: 10.1590/0102-311x00136921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate social and racial inequalities in self-rated oral health in adults from the Brazilian birth cohort study. This study belongs to 1982 Pelotas (Brazil) birth cohort study. Data from this study was collected for oral health conditions 31 years old (Oral Health Study). The outcome was self-rated oral health, dichotomized into positive (good/very good) and negative (regular/bad/very bad). Analyses were stratified by gender, racial/skin color groups, schooling level and income. For statistical analysis, the slope index of inequality (SII) and the concentration index (CIX) were used. The prevalence of negative self-rated oral health was 36.1%. Social inequalities were observed in self-rated oral health in both absolute and relative terms. A SII of -30.0 (95%CI: -43.6; -16.4) was observed for income, and -27.7 (95%CI: -41.9; -13.4) for schooling level. Both the individuals’ income and the schooling level had negative CIX (CIXincome -14.6 [95%CI: -21.2; -8.0] and CIXschooling level -14.1 [95%CI: -20.7; -7.5]). Furthermore, the prevalence of negative self-rated oral health in black/brown/indigenous individuals from the highest income/schooling level was comparable to prevalence of the outcome in the white individuals belonging to the lowest income/schooling levels. This study results demonstrate racial disparities in oral health regardless of income and schooling levels. Furthermore, a higher concentration of negative self-rated oral health was identified among the most socioeconomically vulnerable individuals. Our findings reinforce the presence of racial and socioeconomic inequalities in oral health.
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