Background Dental service utilisation is important as it helps to alleviate pain and suffering, and access to dental treatment. International evidence has shown that racial/ethnic minority groups are less likely to use dental services compared to the White majority population. In Brazil, where the concept of colour/race is used to classify the population, recent research has assessed colour/race inequalities in dental service use amongst the elderly population, but evidence is scarce for other age groups. Therefore, the overall aim of this research is to investigate the differences between colour/race groups (White versus Pardo and Black) in the use of dental service in a national sample of 35 to 44 year-old adults in Brazil taking into consideration the role of individual-level characteristics.
Methods Data from 7902 adults aged 35 to 44 years from the Brazilian National Oral Health Survey (SB Brazil 2010) was used in this study. The survey collected data using an interviewer-administrated questionnaire and clinical examinations. Dependent variables were the time since last dental visit (less than a year, or a year or more), reason for the last dental visit (prevention/check-up, pain or extraction, or treatment), and type of service used (public, or private). The main exploratory variable was self-reported colour/race (White, Pardo, or Black) measured according to the Brazilian Institute of Geography and Statistics (IBGE). Covariates were sex, level of education, family income, satisfaction with teeth/mouth, self-reported need for treatment, self-reported dental pain in the last six months, presence of decayed teeth, filled teeth, and missing teeth. Binary and multinomial logistic regression analyses were conducted weighted for complex sample design.
Results No association between colour/race and time since last dental visit on the fully fitted model was observed. For the comparison between visits due to preventive/check-up and pain or extraction, the association remained significant only for Pardos compared to Whites after the adjustments (RRR 1.63; 95% CI 1.11–2.38). In contrast, there was no association between colour/race and visiting the dentist due to treatment. Results from the adjusted model showed statistical differences only for Blacks, and this group was 1.48 times (95% CI 1.10–1.97) more likely to visit the public dental service compared to Whites.
Conclusion Racial inequalities in dental service utilisation were evident for middle-aged adults in Brazil. For some outcomes, the study showed that colour/race inequalities were not fully explained by the covariates investigated. Further multilevel analysis will be conducted to better understand these inequalities.
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