Racial Differences in Oral Health-Related Quality of Life: A Multilevel Analysis in Brazilian Children

Bruno Emmanuelli, Ângela Aniszewski Kucner, Marjana Ostapiuck, Fernanda Tomazoni, Bernardo Antonio Agostini, Thiago Machado Ardenghi

This cross-sectional study aimed to assess the influence of race/ethnicity on Brazilian children' oral health-related quality of life (OHRQoL). A multistage random sampling selected a representative sample of 1,134 twelve-years-old children from public schools of Santa Maria, a city in Southern Brazil. Participants were examined by 4 calibrated clinicians (minimum Kappa-value for inter-examiner agreement of 0.8) and the Brazilian short version of the Child Perceptions Questionnaire (CPQ11-14) was administered. The children's parents or guardians answered questions regarding their demographics and socioeconomic status. Associations were analyzed using multilevel Poisson regression models. Children from racial/ethnic minority groups had poorer OHRQoL. The mean CPQ11-14 score was 1.08 times higher for non-white children than their white counterparts' score. "Social" and "Emotional well-being" were the most affected domains for non-white children, with significantly higher mean scores as compared to white children (RR 1.19, 95% CI, 1.07-1.33; and RR 1.14; 95% CI 1.04-1.24). This association remained significant even after adjusting for individual and contextual covariates. OHRQoL disparities are prevalent among children from racial/ethnic minority groups. Non-white children have lower OHRQoL compared to white children.