Oral Health Disparities among LGB and Non-LGB Individuals in the United States, 2007-2016

Purpose. Although oral health in America has generally improved over recent decades, health disparities in the field have remained an issue for several marginalized groups, one such being lesbian, gay, and bisexual (LGB) individuals. Few studies have investigated oral health outcomes in LGB individuals in comparison with their heterosexual counterparts. As such, the aim of this study was to examine potential oral health disparities among a national sample of American adults and investigate sex-differences in the association between sexual orientation and poor oral health.

Methods. We used pooled data (2007-2016) from the National Health and Nutrition Examination Survey (NHANES) for men and women aged 18-59. Multiple imputation methods were used to impute missing data. Multiple logistic regression models were used to examine the association between sexual orientation and self-reported oral health, both overall and separately for men and women.

Results. A total of 20,298 responses were included in this analysis. Compared with heterosexuals, LGB individuals had higher odds of reporting poor oral health than heterosexuals in both the unadjusted (OR = 1.20 95% CI = 1.04-1.38) and adjusted (OR= 1.21 95% CI 1.04-1.40), combined analyses. In the unadjusted sex-stratified analyses, sexual orientation was found to have a statistically significant association with poor oral health in females (OR= 1.51 95% CI = 1.26-1.79). After adjusting for covariates, women who were LGB had a 38% statistically significant increased odds of having poor oral health compared with their heterosexual counterparts (OR= 1.38 95% CI 1.14-1.67). Sexual orientation was not associated with poor oral health in males, with adjusted odds close to null comparing LBG men with their heterosexual counterparts (OR = 0.98, 95% CI = 0.74 - 1.29).

Conclusion. This study explored oral health disparities among a large national sample of LGB Americans. Widening disparities continue to persist among minority populations, despite recent progress made in oral health settings. The findings in this study add to the information base of disparities prevalent in the field of oral health and may inform future interventions and public health frameworks.