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Updated: Jun 28, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Are people with dental fear under-represented in oral epidemiological surveys?
Jason M Armfield1, Gary D Slade, A John Spencer
1Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, 122 Frome Road, Adelaide, SA, 5000, Australia. jason.armfield@adelaide.edu.au
Background:
Dental phobia is associated with poorer dental attendance so epidemiological surveys requiring participants to undertake a dental examination may result in an under-representation of participants with high dental fear.
Method:
We compared the dental fear distribution of participants and non-participants in an oral examination component of a national epidemiological survey of oral health. Of 12,606 in-scope dentate people aged 15+ who completed a structured computer-assisted telephone interview (CATI) survey, 5,505 (43.7%) participated in the oral examination. Dental fear was assessed with a single-item measure in the CATI.
Results:
There was a significant difference between the percentages of participants and non-participants who rated themselves as "extremely" afraid, although the absolute difference (1.9%) was small. The association between extreme dental fear and participation was significant (OR = 0.66, 95% CI = 0.56-0.77) in multivariate analyses after controlling for possible confounders. Females with extreme dental fear were also significantly less likely to undertake an oral examination.
Conclusion:
Even though people with dental fear and phobia may delay or avoid dental visits, they do not appear to be appreciably under-represented in oral epidemiological surveys.
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