title: Inequality of Experience of Dental Caries between Different Ethnic Groups of Brazilians Aged 15 to 19 Years.
abstract: BACKGROUND
  The aim of this study was to assess inequality of experience of dental caries, based on race/ethnicity, among Brazilian adolescents aged 15 to 19 years in 2010 and test whether socioeconomic indicators fully explain ethnic differences in dental caries.
  
  
  METHODS
  Data from a National Oral Health Survey conducted in Brazil in 2010 was analysed. Race/ethnicity was self-assigned and modified to White, African descents, East Asian descents, Mixed Race and Indigenous descents. The prevalence of caries experience by race/ethnic group in 2010(n = 5,367) was calculated. Further analysis included conceptual hierarchical modelling and mediation analysis.
  
  
  RESULTS
  Caries experience was 76.9% in 15 to 19 year old Brazilians in 2010. While African descents were 32% more likely to have caries experience than Whites, Mixed Race were 69% more likely to have caries experience than Whites. Hierarchical conceptual modelling analysis confirmed the highly significant association between caries and race/ethnicity. Mixed Race and East Asian descents were 1.44 (95% CI 1.24-1.67) and 1.81 (95% CI 1.02-3.20) times more likely to experience caries than Whites after adjusting for age, sex, education and income. The difference in the likelihood of experiencing caries between Whites and African descents was not statistically significant after adjusting for years of education and family income. The results of mediation analysis confirmed that inequality of caries experience between Whites and Mixed Race and East Asian descents was mediated through education and income. The likelihood that Mixed Race and East Asian descents would experience caries compared to Whites was attenuated, by 14.8% and by 9.5% respectively, after adjusting for years of education and income.
  
  
  CONCLUSIONS
  Data analysis demonstrated that Whites have benefited more from the significant reduction in dental caries experience in 15 to 19 year old Brazilians, as compared to African descents and Mixed Race. Education and income fully explained ethnic inequalities in experience of dental caries between Whites and African descents, and largely explained inequalities between Whites and Mixed Race.
authors.affiliation: Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London. London, United Kingdom.|Faculty of Dentistry, Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Andreia Maria Araújo
authors.initials: AM
authors.lastname: Drummond
authors.affiliation: Faculty of Dentistry, Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Efigênia Ferreira
authors.initials: EF
authors.lastname: Ferreira
authors.affiliation: Faculty of Dentistry, Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Viviane Elisangela
authors.initials: VE
authors.lastname: Gomes
authors.affiliation: Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London. London, United Kingdom.
authors.forename: Wagner
authors.initials: W
authors.lastname: Marcenes
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D001213:Asian; D001938:Brazil / Q000453:epidemiology / Q000208:ethnology; D003731:Dental Caries / Q000191:economics / Q000453:epidemiology / Q000208:ethnology; D003753:Dental Health Surveys; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012959:Socioeconomic Factors; D044465:White People; D055815:Young Adult