ArticleCommunity dentistry and oral epidemiology2018
Oral health-related behaviours do not mediate the effect of maternal education on adolescents' gingival bleeding: A birth cohort study.
Article in Community dentistry and oral epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 20 citations in OpenAlex.
- Patient Anxiety in Oro-Dental Procedures: A Retrospective Observational Study of Biopsychosocial Aspects.Behavioral sciences (Basel, Switzerland) · 2026Article
- Scoping Review of Oral Health-Related Birth Cohort Studies: Toward a Global Consortium.Journal of dental research · 2022Article
- Profile of the oral microbiota from preconception to the third trimester of pregnancy and its association with oral hygiene practices.Journal of oral microbiology · 2022Article
- The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour.BMC oral health · 2021Article
- Dental caries and associated factors in 3 to 5-year-old children in Zhejiang Province, China: an epidemiological survey.BMC oral health · 2019Article
- Oral health-related behaviours do not mediate the effect of maternal education on adolescents' gingival bleeding: A birth cohort study.Community dentistry and oral epidemiology · 2018Article
- Prevalence and Severity of Molar-Incisor Hypomineralization, Maternal Education, and Dental Caries: A Cross-Sectional Study of Mexican Schoolchildren with Low Socioeconomic Status.Journal of International Society of Preventive & Community DentistryArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo test whether maternal education has a direct effect on gingival bleeding in adolescents aged 12 and to assess whether oral health behaviours over time mediate that association.
methodsTwo oral health studies nested in the 1993 Pelotas (Brazil) birth cohort study were carried out in participants aged 6 (n = 359) and 12 years (n = 339). The proportion of teeth with bleeding on probing (BOP) and the median number of teeth with gingivitis at age 12 were recorded. Maternal education at birth was the exposure. Toothbrushing frequency and dental visit at ages 6 and 12 years were investigated as mediators of the association between maternal education at birth and gingival bleeding. Time-varying family income through childhood and adolescence was included as later confounder. Paternal education was taken as baseline confounder. The controlled direct effect (CDE) of maternal education at child's birth on gingival bleeding at age 12 was estimated using marginal structural models (MSM). Additionally, path analysis was employed to estimate standardized direct, indirect and total effects of maternal education at birth on gingival bleeding.
resultsAdjusted analyses using MSM showed that adolescents whose mothers had <8 years of education had 3.82 higher risk of having teeth with gingival bleeding above the median (rate ratio RR 3.82; 95% CI: 1.68-8.19). Low maternal education doubled the proportion of gingival bleeding at age 12 not mediated by dental visit and toothbrushing frequency (RR 1.99; 95% CI: 1.52-2.60). Path analysis revealed that maternal education had a direct effect on gingival bleeding independently of the mediators.
conclusionsThe pattern of oral health behaviours does not explain the association between mother's education and adolescent's gingival bleeding. Individual-based approaches focused on oral health-related behaviours tend to fail to prevent gingival bleeding.
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