Discrimination and microaggressions in dental care are not rare experiences in the United States. For many patients, they shape whether care is delayed, avoided, or never sought at all.

A new national study finds those experiences remain widespread, particularly among younger adults, people of color, and those with fewer economic resources. But the research also uncovers something less expected: patterns of resilience that complicate long-held assumptions about who experiences poor oral health and why.

The study was led by Sarah Raskin, associate professor and program assistant chair in urban and regional studies and planning at Virginia Commonwealth University’s L. Douglas Wilder School of Government and Public Affairs. Published in Community Dentistry and Oral Epidemiology, the open-access paper analyzes survey data from more than 10,900 U.S. adults collected through the 2022 and 2023 State of Oral Health Equity in America survey.

Rather than examining one factor at a time, such as race or income, the researchers used a quantitative approach called latent class analysis. In plain terms, the method identifies groups of people based on shared patterns across many characteristics at once, in this case age, gender, race and ethnicity, income, insurance coverage, oral health behaviors, and experiences of discrimination or microaggressions during dental visits.

The result was six distinct “archetypes” that reflect how these factors combine in real life.

As expected, the analysis showed that one group of adults—younger, more racially and ethnically diverse, and lower-income—were more likely to report discrimination and microaggressions in dental care settings. Those experiences often coincided with delayed care, fewer preventive visits, and poorer self-rated oral health.

But the data also revealed findings that challenge conventional narratives.

One archetype, labeled “America in Transition,” included a predominantly female, racially diverse, and relatively young group. Despite reporting discrimination at rates similar to other marginalized groups, these adults showed comparatively strong oral health outcomes, including higher rates of recent dental visits and preventive behaviors.

Another group, “Ageing in Vulnerability,” also experienced frequent discrimination and indignities, yet fared better than expected when compared with similarly disadvantaged younger adults.

These contradictions matter. They suggest that disadvantage does not operate along a single line and that resilience can emerge even under conditions of persistent bias.

“Findings like these should inspire dental education and practice to develop assets-based, trauma-informed, and culturally humble models of care,” Raskin wrote, emphasizing that diversifying the dental workforce and recognizing patient strengths are critical to improving outcomes.

The study’s discussion points to the importance of viewing oral health disparities through an intersectional lens, one that accounts for people’s overlapping social positions rather than isolating race, income, or age as standalone explanations.

In some cases, the authors note, gender-based coping strategies, community strengths, or relative resource stability may help buffer the harmful effects of discrimination. In others, especially where poverty and insecurity are more severe, those protective factors appear insufficient.

Taken together, the findings suggest that discrimination and indignity in health care settings are not just social harms but structural forces that influence whether patients feel safe, respected, and willing to seek care. Understanding where resilience appears, the authors argue, may be just as important as identifying where inequities persist.