Severe tooth loss influences the perception of racial and gender discrimination among Brazilian older adults

OBJECTIVE: To analyse whether severe tooth loss influences perceived racial and gender discrimination in Brazilian older adults. METHODS: The data were obtained from the Brazilian Longitudinal Study of Ageing, a nationally representative sample of community-dwelling individuals aged 50 and older. The outcome measured was the perception of discrimination in five different settings. The main explanatory variables were self-identified/self-perceived race (Whites and Non-whites) and gender, while covariates included education level, equivalized per capita income, depression, and the use of dental prostheses. Negative binomial and logistic regressions with interaction terms between race, gender and severe tooth loss were used to estimate the intersections between gender and race-related perceived discrimination inequities. RESULTS: The analytical sample comprised 8,556 respondents with complete variables. While the prevalence of perceived discrimination in white Brazilians was 14.3% (95%CI: 12.2;16.3), it was 18.8% (95%CI: 16.8;20.6) among non-Whites. The interaction of being female, non-white and with severe tooth loss showed higher chances of perceived discrimination in 50-59 years [RR = 1.53(95%CI: 1.01;2.28)]. Moreover, being non-white with severe loss in 60-69 years [RR = 1.74(95%CI: 1.13;2.69)] had higher chances of perceived discrimination adjusted by all covariates. A sensitivity analysis of all older adults confirmed the findings. CONCLUSIONS: The findings highlight the intersection between severe tooth loss, race, and gender, with more pronounced associations among women and non-white individuals. These results reinforce the importance of equity-oriented oral health policies and interventions within the Family Health Strategy, particularly for populations experiencing severe tooth loss.