title: Are people with dental fear under-represented in oral epidemiological surveys?
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, 122 Frome Road, Adelaide, SA, 5000, Australia. jason.armfield@adelaide.edu.au
authors.forename: Jason M
authors.initials: JM
authors.lastname: Armfield
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.forename: A John
authors.initials: AJ
authors.lastname: Spencer
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D015982:Bias; D016854:Dental Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D003729:Dental Care / Q000706:statistics & numerical data; D003945:Diagnosis, Oral / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000592:standards*; D009910:Oral Hygiene / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D035842:Research Subjects / Q000523:psychology; D011795:Surveys and Questionnaires