Advances in Dental Research最新文献

This commentary examines how the systematic exclusion of voices across gender, sexuality, and race shapes oral epidemiology to serve the interests of a few powerful groups. Focusing on the core functions of the field, including description of disease patterns, prediction of outcomes, and causal inference, we elaborate on empirical examples to argue for a reorientation of oral epidemiology. We advocate for an approach that centers reflexivity, applies intersectional analyses, and embeds inclusive governance across all stages of knowledge production to advance more equitable oral health outcomes.

The persistent underrepresentation of female animals in biomedical research, particularly in medical and dental sciences, has significant implications for research quality, translational validity and patient safety. In dental preclinical studies, the exclusion of female animals can obscure key biological differences in oral disease pathogenesis, progression and response to treatment, thus compromising the development of effective therapies for diverse populations. Evidence from biomedical research underlines the public health risks of such omission, and parallels in dental science highlight that ignoring sex as a biological variable can jeopardise efficacy and safety in novel oral health interventions. Addressing these gaps requires a systematic, sex-informed approach: from problem identification and research design, through data collection and sex-based disaggregation, to analysis and dissemination of results. Researchers must also assess extrinsic laboratory conditions, such as caging practices, environmental controls and researcher effects, since these may differentially influence male, female and hermaphroditic animal models. In the context of human research, interactions among sex, gender and broader social determinants (eg, age, socioeconomic status, geography, race and ethnicity) are crucial for experimental outcomes. Similarly, dental animal studies must consider how biological traits interact with laboratory environments to avoid misattributing outcomes to sex when they may be driven by external factors. However, many oral health researchers lack training in these advanced methodologies. Thus, dental schools need to integrate sex, gender and intersectional analysis into their curricula, equipping future researchers with the methodological rigour necessary to produce reproducible, equitable and innovative dental science for all populations.

Sex, gender, and sexuality are crucial and interrelated factors influencing oral health outcomes, yet they are often overlooked and inadequately addressed in human studies on oral health. Biological sex influences oral disease susceptibility through hormonal, immunological, and microbiome-related mechanisms. Concomitantly, gender as a social construct modulates health through psychosocial stress, health care access, and societal norms. Sexuality intersects with oral health through behavioral risks, stigma, and discrimination, especially among lesbian, gay, bisexual, transgender, and queer or questioning populations. Despite their importance, oral health research often treats sex as a binary demographic variable, excluding sexual and gender minority individuals. There is a lack of meaningful integration of these variables across all phases of research, from proposal development and data collection to analysis and knowledge creation. This results in limited generalizability, perpetuates health inequities, and impedes the development of inclusive, evidence-based, and person-centered interventions. Furthermore, dental education and research training programs often lack comprehensive content on sex, gender, and sexuality, contributing to research approaches and training that reinforce binary-centered investigations. Substantial gaps in mentorship, representation, and inclusive curricula largely contribute to the underrepresentation of gender-diverse scholars and leaders in oral health. To address these gaps, a multipronged action plan is necessary, including an inclusive research design, robust data collection tools, curriculum reform that integrates person-centered frameworks, community engagement and service-learning, policy change, and accountability mechanisms. The integration of intersectionality, pertinent sex, gender, sexuality, and social determinants of health in oral health research and education is essential for achieving scientific rigor, health equity, and culturally responsive care for all populations.

Sex, gender, and sexual orientation are multidimensional constructs that influence representation, inclusion, and outcomes in the oral health workforce. Despite demographic shifts in dental education, persistent inequities related to these identities remain underexamined in academic, research, and clinical settings. Our goal was to evaluate how sex, gender, and sexual orientation affect equity in the oral health workforce and to propose evidence-based strategies for advancing inclusivity in education and policy. We conducted a narrative synthesis using US-based data sources and peer-reviewed literature to assess demographic trends, historical structures, and institutional barriers. Particular attention was given to leadership disparities, economic inequities, and discrimination faced by women and LGBTQIA+ professionals (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual +). Best practices and policy strategies were also reviewed. Although women now constitute >50% of dental school enrollees, they remain underrepresented in leadership and surgical specialties and experience persistent wage gaps. LGBTQIA+ professionals face limited visibility, compounded bias, and a lack of structural protections. These disparities are amplified by intersecting identities, such as race and caregiving roles. Institutional gaps in inclusive curricula, faculty mentorship, and data collection further constrain equity. However, there have been some national initiatives that demonstrate promise for addressing these challenges. A more inclusive oral health workforce requires systemic reforms in academic policies, leadership development, cultural competency training, and federal financial support. Data collection on gender identity and sexual orientation, bias mitigation, and mentorship programs are critical levers for transformation. Aligning workforce policy with contemporary family structures and demographic realities can help ensure an equitable, representative, and resilient profession.

This study uses an intersectional framework to examine how race, gender, and sexual orientation jointly influence access to dental care in the United States. Leveraging cross-sectional data from the All of Us Research Program, we applied multilevel analysis of individual heterogeneity and discriminatory accuracy to assess disparities in dental service use and affordability across 30 intersectional strata. Results showed substantial inequities, with racialized, gender-diverse, and sexual minority individuals facing greater barriers to care. While most disparities were explained by additive effects, the findings highlight the importance of intersectionality in revealing how layered disadvantage shapes oral health outcomes. This study contributes to a more nuanced understanding of oral health equity by integrating gender and sexual orientation into intersectional health research.

Gender and sexual identity-based inequities remain entrenched within Nigeria's oral health workforce yet remain underexplored in both policy and academic literature. This study explored gender-based disparities and the representation of sexual and gender minority individuals in Africa's oral health workforce, using reanalysis of Nigerian academic interviews and a rapid review of African literature. An inductive analysis of transcripts from in-depth interviews with 54 medical and dental academic researchers in Nigeria was conducted. The analysis explored themes related to gender equity, inclusion, and institutional culture within the oral health workforce. A complementary rapid review was also conducted to assess the representation and roles of sexual and gender minority individuals in oral health care systems across Africa. The findings revealed systemic inequities rooted in patriarchal leadership structures, gendered work-life expectations, limited mentorship, and institutional policies that perpetuate exclusion, particularly for women. While male participants often perceived gender parity as achieved, female respondents reported persistent cultural and institutional barriers. The study also highlights a critical gap: no data or narratives concerning sexual and gender minority individuals within African oral health systems were identified, underscoring their systemic erasure. The study highlights the need for structural transformation to promote gender and sexual diversity within Africa's oral health workforce. It calls for gender-responsive institutional reforms, inclusive policy development, and legal safeguards that address discrimination against marginalized identities, including the urgent need to make visible the experiences of sexual and gender minority individuals within this workforce. A gender-transformative and intersectional approach is essential for achieving equity, fostering representation, and strengthening the resilience of Africa's oral health systems.

Sex and gender are widely recognised as determinants of health, influencing general and oral health outcomes. In this conceptual article, we argue that the potential of sex- and gender-based oral health research to deliver transformative insights into oral health inequalities has been limited by 3 key factors: 1) a lack of theoretical understanding of the difference between sex and gender, 2) the continued conflation of sex with gender in research and 3) the hegemony of a biomedical paradigm in oral health research and its depoliticised view of health and its determinants. Drawing on the precedent set by medicine espousing its 'gender medicine' movement, this article calls for a similar movement within dentistry and oral health research, acknowledging and calling out decades of gender blindness and gender bias. Such a paradigm shift will contribute to the emergence of 'gender-conscious' dentistry. We describe gender-conscious dentistry as a discipline where gender is foregrounded in its theoretical, methodological and empirical work. The article concludes by highlighting ways that oral health research can achieve this goal. Overall, this article is an invitation for further discussion and debate on the role and place of sex and gender in oral health research.

Oral mucositis is a significant side effect of chemotherapy, radiotherapy, or their combination in cancer patients. Current clinical management focuses primarily on symptom control, with few effective therapeutic agents. Understanding the factors influencing susceptibility to oral mucositis is essential for a comprehensive grasp of its pathophysiology. This study investigates sex as a biological variable in radiation-induced oral mucositis. Oral mucositis was induced via X-ray ionizing radiation using a fractionated dose of 8 Gy/d for 5 consecutive days, targeting only the head and neck area using male and female C57BL/6J mice aged 7 to 9 wk. Following sex-guided time points, we harvested tongues, stained with toluidine blue, and imaged to visualize mucosal damage. Histopathological analyses were performed using hematoxylin and eosin staining to assess mucositis severity and inflammatory infiltration. All irradiated groups showed a significant increase in mucositis severity versus controls, measured by the total number and area of ulcerative lesions as well as inflammatory cell infiltrate. Notably, there was a significant decrease in epithelial thickness in irradiated mice compared with nonirradiated controls, consistent with oral mucositis. Furthermore, female mice exhibited a greater area of ulcerative lesions and higher inflammatory cell infiltrate scores than males did. This study highlights the sexual dimorphism in the murine model of fractionated ionizing radiation-induced oral mucositis, demonstrating that female mice have an increased susceptibility to irradiation treatment.