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Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze intersectional inequalities in dental service utilization and functional dentition among Brazilian adults aged 18\u201349 years, considering sex, skin color, and income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross-sectional analysis of 64,811 adults reporting dental service use and 64,513 reporting functional dentition. Age-adjusted prevalences were estimated using Poisson regression with robust variance for combined sex\/skin color\/income strata. Absolute differences were calculated relative to White men with income above one minimum wage. Interaction contrasts on the additive scale (RERI) assessed departures from additivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Black\/Brown men with low income had the lowest utilization (33.6% vs. 57.8%; \u221224.2% points [p.p.],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while White women with high income had the highest (+\u20096.3 p.p.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For absence of functional dentition, White women with low income had the highest prevalence (19.1% vs. 8.9%; +10.2 p.p.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), followed by Black\/Brown women with low income (14.8%; +5.9 p.p.,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Income was the strongest predictor: service use decreased (\u2212\u200912.8 to \u2212\u200924.2 p.p.) and tooth loss increased (+\u20094.6 to +\u200910.2 p.p.) across low-income groups, regardless of sex or skin color. Both outcomes showed sub-additive interaction contrasts, with joint effects not exceeding the sum of individual contributions (RERI for dental service use: \u22123.27 [95% CI: \u22126.52 to \u2212\u20090.02]; RERI for non-functional dentition: \u22122.45 [95% CI: \u22125.18 to 0.28]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intersectional inequalities were concentrated in low-income groups, with distinct patterns for women. The high burden of tooth loss among low-income White women suggests that socioeconomic and gender-related vulnerabilities may override racial privilege, rather than reflecting simple cumulative disadvantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-03124-6","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:16:08Z","timestamp":1785442568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intersections Between Skin Color, Sex and Income in Oral Health Disparities: A Population-Based Assessment of Brazilian Adults"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9674-9777","authenticated-orcid":false,"given":"\u00c9chiley","family":"da Silva Rios","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5548-7408","authenticated-orcid":false,"given":"Maria Laura Braccini","family":"Fagundes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7792-8032","authenticated-orcid":false,"given":"Jessica Kl\u00f6ckner","family":"Knorst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-0832","authenticated-orcid":false,"given":"Bruno","family":"Emmanuelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-740X","authenticated-orcid":false,"given":"Thiago Machado","family":"Ardenghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3825-9734","authenticated-orcid":false,"given":"Jessye Melgarejo","family":"do Amaral Giordani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6611-3871","authenticated-orcid":false,"given":"Orlando Luiz","family":"do Amaral J\u00fanior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"4","key":"3124_CR1","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1086\/669575","volume":"38","author":"JJ Chun","year":"2013","unstructured":"Chun JJ, Lipsitz G, Shin Y. 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