Sexual orientation‐related oral health disparities in the United States

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.

A multicenter, multidisciplinary evaluation of 1701 healthcare professional students’ LGBT cultural competency: Comparisons between dental, medical, occupational therapy, pharmacy, physical therapy, physician assistant, and social work students

“…In reality, the LGBT population faces increased oral health disparities, notably oral human papillomavirus (HPV) prevalence, as well as systemic barriers to receiving dental care. [17] Thus, a dental professional's awareness of a patient's LGBT identity could increase vigilance during oral care and may lower a provider's threshold for HPV testing on suspect lesions.…”

What is intersectionality and why is it important in oral health research?

“…The roots of intersectionality were also evidenced by the Black feminist organization, the Combahee River Collective, in their 1982 statement 14 . This statement argued that because sexism, racism, classism, and homophobia were interlocking systems of oppressions, solutions seeking to dismantle any of these structures had to be interwoven 6 …”

“…Several researchers have unmasked important intersections in their research; however, these often remain latent because of this homogenization. For example, a study by Schwartz et al 6 on oral health inequalities associated with sexual orientation (divided as Gay/Lesbian, Bisexual, exclusively Heterosexual and “Homosexually experienced”) misses an opportunity to understand the complexity of how sexual orientation intersects with gender, race and ethnicity, income, and education to produce oral health problems. Similarly, while Delgado‐Angulo et al 34 used intersectionality theory to explore the association between ethnicity and immigration status and caries, in using adjusted regression models to identity independent effects and dominant identities, they applied a multiplicative approach 41 .…”

“…Despite significant progress in identifying which social identities influence the oral health of individuals and populations, oral health research has largely overlooked the interrelationship among these social identities and how these interrelationships produce health outcomes. The tendency has been to examine “variables” such as race and ethnicity, gender, sexuality and class in isolation 5,6 . Rather than viewing each of these social categories as separate entities, Hulko 7 contends that it is the “entanglement of identities that makes up an individual”.…”

População LGBTQIA+

“…Frente a transtornos mentais elas apresentam maior taxa de depressão e ansiedade. Já os bissexuais são menos saudáveis que gays, lésbicas e heterossexuais e possuem comportamentos de risco como abuso de substâncias, maior risco de infecção pelo papilomavirus humano (HPV) 16 e vírus da imunodeficiência humana (HIV), altas chances de contrair hepatite e desenvolver compulsão alimentar. 24 Pesquisa qualitativa sobre o conhecimento e preparo para o atendimento da população LGBTQIA+ de alunos de graduação de áreas da saúde.…”