The impact of mother's literacy on child dental caries: Individual data or aggregate data analysis?

INTRODUCTION: To evaluate the impact of mother's literacy on child dental caries based on a national oral health survey in Iran and to investigate the possibility of ecological fallacy in aggregate data analysis. MATERIALS AND METHODS: Existing data were from second national oral health survey that was carried out in 2004, which including 8725 6 years old participants. The association of mother's literacy with caries occurrence (DMF (Decayed, Missing, Filling) total score >0) of her child was assessed using individual data by logistic regression model. Then the association of the percentages of mother's literacy and the percentages of decayed teeth in each 30 provinces of Iran was assessed using aggregated data retrieved from the data of second national oral health survey of Iran and alternatively from census of “Statistical Center of Iran” using linear regression model. The significance level was set at 0.05 for all analysis. RESULTS: Individual data analysis showed a statistically significant association between mother's literacy and decayed teeth of children (P = 0.02, odds ratio = 0.83). There were not statistical significant association between mother's literacy and child dental caries in aggregate data analysis of oral health survey (P = 0.79, B = 0.03) and census of “Statistical Center of Statistics” (P = 0.60, B = 0.14). CONCLUSION: Literate mothers have a preventive effect on occurring dental caries of children. According to the high percentage of illiterate parents in Iran, it's logical to consider suitable methods of oral health education which do not need reading or writing. Aggregate data analysis and individual data analysis had completely different results in this study.