The Causal Effect of Education on Tooth Loss: Evidence from UK Schooling Reforms

Abstract

Associations between education and oral health have frequently been reported, but until now there is no causal evidence. Exploiting exogenous variation in years of schooling due to 1947 and 1972 reforms in mandatory schooling in the UK; we examined the causal relationship between education and tooth loss in older age. A cross-sectional study was conducted using data from the English Longitudinal Study of Ageing (waves 3, 5 and 7). A Two-Stage Least Squares instrumental variables approach was employed. 5,667 respondents (average age = 67.8; 44.4% were men) were included in the analyses, of which 819 (14.5%) had no teeth. The schooling reforms increased years of education by an average of 0.624 years (95% CI: 0.412, 0.835). For respondents born within +/−6 years from the pivotal cohorts, a one-year increment of education causally reduced edentulism by 9.1 (95% CI: 1.5, 16.8) % points. The effects were stronger for the 1947 reform than for the 1972 reform. Results were robust against broadening the cohort bandwidth and functional form of the cohort trend. The findings suggest oral health later in life improves in return to investments in school education.