Racial disparities in the prevalence of periodontal disease are consistent and persistent. The epidemiology of periodontal disease demonstrates racial inequities: non‐Hispanic Black (14.7%), Mexican American (13.4%), and other Hispanic adults (7.8%) experience a higher prevalence of severe periodontal disease than non‐Hispanic White adults (5.9%). Epidemiologic and clinical research on periodontal health suffers from the same problem that has plagued the health equity movement, an over emphasis on describing racial inequities coupled with few interventions that reduce racial health inequity. Over the decades that racial inequities in periodontal disease have been observed, many have argued that systemic racism is the fundamental driver of racial health inequity. This paper interrogates the roles of systemic racism, dental education, clinical treatment, and patient behavior in periodontal disease. We describe how, together, these mechanisms contribute to racial disparities in periodontal outcomes. However, it is insufficient for oral health equity scientists to only describe and discuss the negative effects of systemic racism. The imperative is to create antiracist strategies designed to eliminate systemic racism. Health equity scientists must also specify how dental systems operate in a racist manner and create effective clinical strategies designed to reduce racial disparities in periodontal disease.

中文翻译：

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牙周健康中的系统性种族主义和种族不平等：从上游决定因素到下游治疗的漫长旅程


牙周病患病率的种族差异是一致且持久的。牙周病的流行病学表明种族不平等：非西班牙裔黑人 (14.7%)、墨西哥裔美国人 (13.4%) 和其他西班牙裔成年人 (7.8%) 的严重牙周病患病率高于非西班牙裔白人成年人 (5.9%) ）。牙周健康的流行病学和临床研究也面临着困扰健康公平运动的同样问题，即过分强调描述种族不平等，而很少采取减少种族健康不平等的干预措施。几十年来，人们观察到牙周疾病中的种族不平等，许多人认为系统性种族主义是种族健康不平等的根本驱动因素。本文探讨了系统性种族主义、牙科教育、临床治疗和患者行为在牙周病中的作用。我们描述了这些机制如何共同导致牙周结果的种族差异。然而，口腔健康公平科学家仅仅描述和讨论系统性种族主义的负面影响是不够的。当务之急是制定旨在消除系统性种族主义的反种族主义战略。健康公平科学家还必须明确牙科系统如何以种族主义方式运作，并制定有效的临床策略，旨在减少牙周病的种族差异。