Discrimination, gender and self-reported aesthetic problems among Brazilian Adults

Objectives: To explore factors associated with discrimination in healthcare services and to assess whether discrimination based on dental aesthetics differs by sex. Methods: Cross-sectional analysis based on a household survey carried out in a city in Southern Brazil. Fifteen primary health care (PHC) units with a dental team were randomly selected, and individuals who used the public services in the catchment areas of the PHC units were interviewed. The survey questionnaire included experiences with discrimination related to health services, sociodemographic and dental characteristics. Multiple logistic regressions were estimated with dental appearance as outcome. Results: The final sample was composed of 433 individuals, with 15.2% reporting being discriminated in health services. Participants with ≥20 teeth were significantly more likely to report discrimination than those with <20 teeth (16.6% vs 9.1%, respectively), and people with twisted and stained teeth reported more discrimination than those with white and aligned teeth (23.2% vs 9.9%, respectively). Overall, individuals with twisted and stained teeth were more likely to report discrimination (OR=3.13; 95% CI: 1.46-6.71). When the analyses were stratified by sex, women with twisted and stained teeth showed an OR=3.62 (95% CI: 1.55-8.46) and men OR=0.54 (95% CI: 0.05-6.18). Conclusion: Dental appearance may lead to discrimination in healthcare services, but this seems to be more important for women than men.