Volume 79, Issue 1 pp. 18-24
ORIGINAL ARTICLE

Sexual orientation-related oral health disparities in the United States

Scott B. Schwartz DDS, MPH

Corresponding Author

Scott B. Schwartz DDS, MPH

Division of Pediatric Dentistry and Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

Correspondence

Scott B. Schwartz, Cincinnati Children's Hospital Medical Center, Division of Pediatric Dentistry and Orthodontics, 3333 Burnet Ave, MLC 2006. Cincinnati, OH 45229, USA. Tel.: 513-636-5963; Fax: 513-636-8283; e-mail: [email protected]

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Anne E. Sanders MS, PhD, MS

Anne E. Sanders MS, PhD, MS

Department of Dental Ecology, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, 27599, USA

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Jessica Y. Lee DDS, MPH, PhD,

Jessica Y. Lee DDS, MPH, PhD,

Department of Pediatric Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, 27599, USA

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

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Kimon Divaris DDS, PhD

Kimon Divaris DDS, PhD

Department of Pediatric Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, 27599, USA

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

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First published: 02 October 2018
Citations: 24

Abstract

Objective

Recent reports have documented health disparities according to sexual orientation and used the minority stress model as a framework for understanding their origins. To date, however, sexual orientation-related disparities in the oral health domain have not been evaluated. Accordingly, this study sought to investigate potential health disparities in objectively-assessed and subjective reports of oral heath among lesbian, gay, and bisexual adults relative to the heterosexual community-dwelling US population.

Methods

We used three consecutive cycles (2009–2014) of National Health and Nutrition Examination Survey (NHANES) data for men and women aged 18–59 years. We examined clinical measures of dental caries, tooth loss, chronic periodontitis, and oral human papillomavirus (HPV) as well as subjective reports of oral health status and use of dental services.

Results

Clinical measures of oral disease did not differ according to sexual orientation; however, bisexual adults were more likely to rate their oral health unfavorably (41%) than heterosexual adults (27%). Gay men reported “bone loss around teeth” more frequently (35%) than heterosexual (11%) and bisexual (10%) men. Bisexual individuals were more likely to confront barriers to accessing dental care (30%) versus heterosexual adults (19%).

Conclusions

While clinical measures of oral health did not substantially differ between sexual orientation strata, subjective measures of oral health were worse among gay, lesbian, and bisexual adults versus heterosexual adults. Further study of the psychosocial construction of oral health among sexual minorities is warranted.

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