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Updated: Feb 26, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Performance of the Index of Dental Anxiety and Fear in a population-based sample of adults
H Ibrahim1, K M Lyons1, J M Armfield2
1Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand.
Background:
The Index of Dental Anxiety and Fear (IDAF-4C) was introduced to overcome the theoretical and practical shortcomings of previously developed dental fear measures. This new scale has not been tested on population samples other than in its country of origin, Australia. The aim of this study was to validate the IDAF-4C in a different cultural setting and to determine the prevalence and sociodemographic associations of dental anxiety.
Methods:
A cross sectional study of a representative New Zealand adult population sample was undertaken. The questionnaire was mailed to 523 randomly-selected participants. Data were collected on sociodemographic characteristics, oral and general health care, and dental anxiety using both the IDAF-4C and the Dental Anxiety Scale (DAS).
Results:
The response rate was 51.8%. The factor structure of the IDAF-4C was confirmed. The prevalence estimates for high dental anxiety and fear were 18.6% using the DAS and 13.0% using the IDAF-4C. Mean scores for the IDAF-4C and DAS were higher among episodic dental visitors and those without a recent dental visit.
Conclusions:
The performance of the IDAF-4C in this New Zealand community sample supports its use for dental anxiety measurement.
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