Race in public health dentistry: a critical review of the literature

Abstract

OBJECTIVE To carry out a critical review of the literature on the use of race, color, and ethnicity in the field of public health dentistry. METHODS A literature search was conducted in MEDLINE via PubMed for articles published between 2014 and 2019. Using a data extraction form, we collected information on (1) bibliographic characteristics of the selected papers; (2) race, color, and ethnicity of the study participants and their sociodemographic profiles; and (3) the extent to which the original publications followed the recommendations by Kaplan and Bennett (2003) on the use of race, color, or ethnicity in biomedical research. RESULTS Our initial search identified 2,032 articles, 53 of which were selected for full-text examination and assessment following pre-established eligibility criteria. Around 60% (n = 32) of the included studies did not justify the use of race, color, or ethnicity in their analyses, and 9% (n = 5) took these variables as indicators of the participants’ genetic makeup. On the other hand, 68% (n = 36) of the reviewed papers considered race, color, and ethnicity as risk markers – not risk factors – for adverse oral health outcomes, whereas 80% (n = 42) adjusted racial/ethnic inequities for a range of socioeconomic and demographic factors in statistical models. Only one study (2%) explicitly took race, color, or ethnicity as a contextually dependent dimension of the participants’ identities. CONCLUSION Our findings indicate that research on oral health inequities is often based on reductionist and stigmatizing conceptions of race, color, or ethnicity. Such harmful misconceptions should be replaced with anti-racist narratives in order to effectively address racial oral health inequities.

Research on racial/ethnic inequities in oral health over the past 80 years: The role of racism

“…In this study, only a few articles described the role of race and ethnicity in their analytical models, a finding also reported elsewhere (Reginaldo et al, 2022; Susarla et al, 2014). Some studies stated that race/ethnicity was a proxy for SEP, whereas others used it as an effect modifier.…”

“…Therefore, we argue that any relation between race/ethnicity and oral health should be interpreted in the context of hierarchy and oppression (Berman & Paradies, 2010). Nevertheless, it is common to see genetic‐based explanations for racial/ethnic oral health inequities (Bastos et al, 2018; Reginaldo et al, 2022) despite the lack of meaningful biological differences, between race‐ or ethnicity‐based groups (Gravlee, 2009; Templeton, 2013).…”