Self-reported sexual assault and dental service use among adolescents: The moderating role of dental pain.

This study investigated the association between self-reported sexual assault and dental service utilization among Brazilian adolescents (13-17-yr), considering sex differences and the moderating role of dental pain. Cross-sectional analyses using data from the 2019 Brazilian National School Health Survey were performed with stata 18.5, applying survey weights. The outcome was dental service use in the previous year, and the exposure was lifetime self-reported sexual assault. A total of 124,106 adolescents were included; 50.4% were female and 66.3% aged 13-15-yr. Overall, 66.7% reported dental visits in the previous year, 18.6% reported dental pain, and 6.2% reported sexual abuse. Adolescents with a history of sexual assault showed lower prevalence of dental service use compared with their non-abused peers (prevalence ratio [PR] = 0.96; 95% confidence interval [CI]: 0.92-1.00), particularly among girls (PR = 0.94; 95% CI: 0.89-0.98). Dental pain was associated with a modest increase in dental service utilization across all groups, with no evidence of effect modification. These findings suggest that sexual abuse is linked to reduced engagement with dental services during adolescence, especially among females, although the magnitude of this association is modest. The results emphasize the importance of trauma-informed and intersectoral strategies to improve access to oral healthcare for vulnerable populations.