Abstract
BACKGROUND: Quilombolas are ethnic-racial groups with black ancestry and territorial ties to quilombo remnants. In 2023, the IBGE identified 494 Quilombola Territories in Brazil, housing about 1.3 million people (0.65% of the population). Historically marginalized, especially in health rights, Social Markers of Difference, such as race, class, and sex, impact the quality of life of Quilombolas. Social determinants like income and education contribute to health inequalities, particularly in oral health. Intersectionality helps analyze how different social markers interact. This study uses intersectionality to examine the oral health of children in a Quilombola community in northeastern Brazil, highlighting complex influencing factors. METHODS: A cross-sectional, population-based epidemiological survey was carried out in a quilombola territory in the municipality of João Pessoa-PB, with children aged 5 to 8 years. The dmfs index (decayed, missing due to caries and filled primary teeth) and DMFS (decayed, missing due to caries and filled permanent teeth), and the pufa/PUFA index (consequence of untreated caries) were used. Three multilevel regression models were obtained, where the dependent variables were: dental caries experience, untreated dental caries, and PUFA index. Variables with p < 0.05 were considered statistically significant, highlighting the influence of Social Determinants of Health and social markers of difference on the health and intersectionality of vulnerable populations. RESULTS: In the Poisson multilevel regression model the intersection between self-attribution as Quilombola and cariogenic diet is associated with dental caries experience (PR = 1.84, CI 95% 1.04-3.26, p = 0.03) and untreated dental caries (PR = 2.82, CI 95% 1.12-7.07, P = 0.02). The intersection between self-attribution as Quilombola and ethnic-racial declaration is associated with dental caries experience (PR = 5.69, CI 95% 3.2-10.11, P < 0.001) and untreated dental caries (PR = 10.34, CI 95% 2.96-36.66, p < 0.001). CONCLUSIONS: Self-attribution as quilombola, socioeconomic factors, and cariogenic diet are associated with the experience of dental caries and untreated dental caries in the quilombola territory, highlighting the influence of SDH and social markers of difference on the health of vulnerable populations.