Perceived racial discrimination, resilience, and oral health behaviours of adolescents with immigrant backgrounds

PLoS One. 2025 Jan 3;20(1):e0313393. doi: 10.1371/journal.pone.0313393. eCollection 2025.

Abstract

Introduction: Unmet oral health needs remain a significant issue among immigrant adolescents, often exacerbated by experiences of racial discrimination. This study aimed to examine the associations between perceived discrimination and oral health behaviours in adolescents with immigrant backgrounds and explore the potential moderating role of resilience on this association.

Methods: Ethical approval for this cross-sectional study was obtained from the University of Alberta Research Ethics Board. Participants were 12 to 18-year-old adolescents from immigrant backgrounds. Participants were recruited through nine community organizations using a snowball sampling technique. After obtaining active parental consent and assent from the adolescent, the participants completed a questionnaire covering demographics, oral health behaviours, and perceived racial discrimination and resilience. Perceived racial discrimination and resilience were measured using validated scales. Descriptive statistics summarized variables. Logistic regression assessed associations, controlling for confounding factors. Resilience's moderating impact was analyzed via the interaction model of regression analysis.

Results: In this cross-sectional study of 316 participants, average age of 15.3 (SD = 1.9) years, and a median age of 15 years (Inter Quartile Range-12-18), 76% reported discrimination experiences. Adjusted analysis showed that an increase of one unit in the total discrimination distress score was associated with 51% less likelihood of categorizing self-rated oral health as good (OR = 0.49, 95% CI: 0.29-0.81). The odds of brushing teeth more than twice a day, as opposed to once a day, decreased by 58% with one unit increase in the total discrimination distress score (OR = 0.42, 95% CI: 0.25-0.71). The odds of visiting the dentist for an urgent procedure instead of a regular check-up were 2.3 times higher with a unit increase in the total discrimination distress score (OR = 2.3: 95% CI:1.3-4.0) Resilience did not moderate the observed association.

Conclusion: Perceived racial discrimination was associated with the pattern for dental attendance, tooth brushing frequency, and self-rated oral health. Resilience did not moderate the observed association.

MeSH terms

  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Emigrants and Immigrants* / psychology
  • Female
  • Health Behavior
  • Humans
  • Male
  • Oral Health*
  • Racism* / psychology
  • Resilience, Psychological*
  • Surveys and Questionnaires

Grants and funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the University of Alberta, School of Dentistry Oral Health Community Engagement Fund (grant number- OHCEF-2022-01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.