Estimating the effects of maternal education on child dental caries using marginal structural models: The Longitudinal Study of Indigenous Australian Children.
To estimate the effect of mothers' education on Indigenous Australian children's dental caries experience while controlling for the mediating effect of children's sweet food intake.



The Longitudinal Study of Indigenous Children is a study of two representative cohorts of Indigenous Australian children, aged from 6 months to 2 years (baby cohort) and from 3.5 to 5 years (child cohort) at baseline. The children's primary caregiver undertook a face-to-face interview in 2008 and repeated annually for the next 4 years. Data included household demographics, child health (nutrition information and dental health), maternal conditions and highest qualification levels. Mother's educational level was classified into four categories: 0-9 years, 10 years, 11-12 years and >12 years. Children's mean sweet food intake was categorized as <20%, 20-30%, and >30%. After multiple imputation of missing values, a marginal structural model with stabilized inverse probability weights was used to estimate the direct effect of mothers' education level on children's dental decay experience.



From 2008 to 2012, complete data on 1720 mother-child dyads were available. Dental caries experience for children was 42.3% over the 5-year period. The controlled direct effect estimates of mother's education on child dental caries were 1.21 (95% CI: 1.01-1.45), 1.03 (95% CI: 0.91-1.18) and 1.07 (95% CI: 0.93-1.22); after multiple imputation of missing values, the effects were 1.21 (95% CI: 1.05-1.39), 1.06 (95% CI: 0.94-1.19) and 1.06 (95% CI: 0.95-1.19), comparing '0-9', '10' and '11-12' years to > 12 years of education.



Mothers' education level had a direct effect on children's dental decay experience that was not mediated by sweet food intake and other risk factors when estimated using a marginal structural model.
Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia. xiangqun.ju@adelaide.edu.au.
Xiangqun
X
Ju
Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.
Lisa M
LM
Jamieson
Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.|School of Dental Medicine, East Carolina University, Greenville, NC, USA.
Gloria C
GC
Mejia
D000328:Adult; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology* / Q000208:ethnology; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D055815:Young Adult
D004040:Dietary Carbohydrates
Child dental health; Indigenous; education level; marginal structural model (MSM); multiple imputation (MI); sweet food intake