Comparison between the DMF indices and two alternative composite indicators of dental health

The DMFT and DMFS indices employed in the majority of oral epidemiological studies have several limitations. In response to this problem, Sheiham et al. (Community Dent Health 1987;4:407–14) proposed two alternative dental health indicators: the number of functioning teeth (hereafter referred to as FS-T) and tissue health (T-Health). Using data from an epidemiological study on the dental health status of adults aged 35–44 from Quebec ( N =2110), this article compares the alternative indices with the conventional DMFT and DMFS indices. By comparing Pearsons correlation coefcient for the four indices in this study with the number of decayed, missing andlled surfaces, it is noted that the FS-T index bears the strongest correlation to the three variables. It is also the only index whose correlation coefcient is greater than 0.3 for each of the three DMFS components. A risk group was created for each index, composed of the 18% of people demonstrating the poorest index. The risk groups's FS-T index results in an average of 4.3 decayed surfaces (compared with 2.6 for the DMFT), 92.7 missing surfaces (74.4 for the DMFT) and 9.0 filled surfaces (compared with 26.9 for the DMFT). Using linear regression analysis with each index as a dependent variable, and peoples socio-demographic characteristics, regular use of dental services and perception of dental health as independent variables, it appears that the percentage of the explained variance (R²) is 21.2% for the FS-T index, 13.8% for the T-Health index, 12.3% for the DMFS index and only 7.6% for the DMFT index.     

Dental caries in postwar Bosnia and Herzegovina

OBJECTIVES: To present the prevalence of dental caries in postwar Bosnia and Herzegovina (BH). METHODS: A survey focused on dmft and DMFT indices was carried out in four cantons of the Federation of BH in 1997. The dental health of 6- and 12-year-olds was assessed in random samples (n = 238 and 318, respectively). DMFT index in adult population was assessed in clients coming to dental offices in the same area (35-44-year-olds; n = 401). All the subjects were clinically investigated. RESULTS: During the 1991-95 war, all four cantons were affected by the migration of population. The population per dentist ratio considerably increased in three cantons. In 6-year-olds, the average dmft (+/-SD) was 4.9 +/- 4.0, and 86% of the children were affected with dental caries. The average DMFT of 12-year-olds was 6.2 +/- 3.9. On the average, 94% of the 12-year-olds were affected with dental caries. Mean DMFT of adult clients was 15.1 +/- 7.0. Almost every adult (98%) was affected with dental caries. CONCLUSIONS: The dental status in postwar BH is rather poor and the mean DMFT in all investigated age groups may be considered high. The detrimental effect of 1991-95 war on social conditions and the health care system should be considered in explaining such poor dental health. Despite the limitations, the presented data may be used to assess the treatment needs, assure the visibility for dental issues in BH, and help the west European countries to plan dental services for refugees from BH.     

Oral health status of children and adults in the Republic of Niger, Africa

The present study was undertaken in order to describe the oral health status of children and adults in the Republic of Niger and to provide baseline data for the organisation and evaluation of systematic oral health promotion programmes in the country. The WHO pathfinder sampling procedures were applied to obtain representative samples of the following age groups: 6 years (n = 373); 12 years (n = 400); 18 years (n = 300) and 35-44 years (n = 400). Data were collected in 1997 according to the WHO methods, including information on dental caries and CPITN. In 6-year-olds, 56 per cent had caries and a mean score of 1.3 DMFT was observed among the 12-year-olds; the 35-44-year-olds had an average score of 5.7 DMFT. Differences in dental caries prevalence were found according to sex, province and urbanisation. Ninety-nine per cent of individuals at age 18, and 87 per cent at age 35-44 had maximum CPITN score 2 (calculus). Where 6- and 35-44-year-olds are concerned, the data may indicate increasing levels of dental caries. The implementation of primary prevention and community-based oral health education is therefore a matter of urgency.     

Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To analyse the oral health status of children and adults in rural and urban areas of Burkina Faso; to provide epidemiological data for planning and evaluation of oral health care programmes. DESIGN: Cross-sectional survey including different ethnic and socio-economic groups. SAMPLE AND METHODS: Multistage cluster sampling of households in urban areas and random samples of participants selected based on the recent population census in rural areas. The final study population covered four age groups: 6 years (n = 424), 12 years (n = 505), 18 years (n = 492) and 35-44 years (n = 493). Clinical oral health data collected according to WHO methodology and criteria. RESULTS: At age 6, 38% of children had caries, with prevalence higher in urban than rural areas. At age 12, the mean DMFT was 0.7 with prevalence significantly higher among urban than rural children. Mean DMFT was 1.9 in 18-year-olds and 6.3 in 35-44-year-olds and figures were higher for women than men. In adults, no differences in caries experience were found by location whereas the caries index was significantly affected by ethnic group and occupation. CPI score 2 (gingivitis and calculus) was dominant for all ages: 6 years (58%), 12 years (57%), 18 years (58%), 35-44 years (49%). In addition, 10% of 35-44-year-olds had CPI score 4. Rural participants had more severe periodontal scores than did urban individuals. CONCLUSIONS: Health authorities should strengthen the implementation of community-based oral disease prevention and health promotion programmes rather than traditional curative care.     

Comparison of ranking dental status using the Significant Caries Index and the Significant Filled and Sound-Teeth Index

OBJECTIVE: The objective was to test whether the ranking of countries was different using the SFS-T (Significant Filled Sound-Teeth Index) or the Significant Caries Index (SIC). METHOD: This study compared the country rankings using the SiC and the SFS-T indices in 12 year olds in a range of countries. The SFS-T is the one-third of the population with the lowest filled or sound teeth and is a measure of functional status. We used the SiC and DMFT data from the WHO database for 12 year olds. SFS-T index values were estimated for the 12 year olds for 16 countries. RESULTS: The ranking by SiC index scores was lower for developed countries than for developing countries. CONCLUSIONS: These findings suggest that it may be more useful to use the SFS-T index than the SiC index in studies comparing dental status between countries.     

Dental caries in adult Lithuanians

There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52%) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35-44-year-olds and 11% of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (>1.5 ppm F/l) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.     

Dental caries in adult Lithuanians

There are few data on the incidence of dental caries in Lithuanian adults. The aim of the present study was to describe caries and treatment experience among 35-44 and 65-74-year-olds, and to relate this to certain selected independent variables (gender, urban/rural residence, drinking water fluoride levels, and years of education). A total of 680 subjects selected based on a stratified random sampling procedure (response rate 52%) were examined by one examiner. Dental caries was recorded as DMFT following the WHO recommendations. The results showed that the median DMFT scores were 18 for the 35-44-year-olds (n = 380) with median DT = 2, MT = 5, FT = 7. For the 65-74-year-olds (n = 300) the median DMFT was 24, with DT = 1, MT = 18, FT = 2, respectively. One percent of all 35 year-olds and 11% of 65-74-year-olds were edentulous. In the younger age group, statistically significant differences in the DMFT scores were related to gender, urbanization and drinking water fluoride levels. Participants from areas with high fluoride content in the drinking water (> 1.5 ppm F/1) had lower DT, MT, and FT values. Females and participants from urban areas had higher numbers of FT. Participants with more years of education had lower DT, MT, and higher FT values. In the elderly, DMFT scores were related to water fluoride levels and years of education. Individuals with more years of education had higher numbers of FT and lower MT values in this age group. Poor oral hygiene was associated with high numbers of DT in both age groups. The data indicate that dental caries is widespread among adult Lithuanians.     

Dental caries trends in Africa

OBJECTIVES: To determine trends in published dental caries rates in Africa. METHODS: A systematic review of published information 1967-1997 was done on-line with the key words dental caries and the name of each of the 35 countries in sub-Saharan mainland Africa. For inclusion in the analysis WHO methods had to have been used for 5- to 6-, 11- to 13-, 14- to 15- and 35- to 44-year-old indigenous Africans. RESULTS: Of 327 papers published in the study period 69 were proper epidemiological studies and 45 fulfilled inclusion criteria. The groupings of caries prevalence and severity were evaluated. In two, significant declines in caries severity were seen for 5- to 6- and 35- to 44-year-olds. Of the remaining eight groupings there were non-significant decreases in five and increases in three. CONCLUSIONS: The study showed a predominantly downward trend in dental caries which was statistically significant for DMFT at age 5 to 6 years and for DMFT at 35 to 44 years.     

The second national survey of oral health status of children and adults in China

OBJECTIVES: To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. DESIGN: Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations. SETTING: National survey by National Committee for Oral Health. SUBJECTS: Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals. RESULTS: At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare. CONCLUSION: The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.     

Prevalence and severity of dental caries in 5- and 12-year old children in the Veneto Region (Italy)

OBJECTIVES: To evaluate the occurrence of dental caries among 5- and 12-year-old children in Northeastern Italy and to compare dental status between immigrants and native-born children. BASIC RESEARCH DESIGN AND PARTICIPANTS: A cross-sectional survey of 260 5-year-olds and 862 12-year-olds was carried out between October 2003 and May 2004. Dental caries were diagnosed at the caries into dentine (D3) threshold. Differences in dental health status were compared between immigrant and native-born children for both age groups. RESULTS: Among 5-year-old children, mean dmft was 1.45 (SD=2.69), SiC=4.31, 65.8% had no caries. Immigrant 5-year-olds (6.2%) scored more poorly than their Italian counterparts: mean dmft was 5.12 (vs. 1.21; p<0.001) and only 25.0% were caries free (vs. 68.4%; p<0.001). Among 12-year-olds, mean DMFT was 1.44 (SD=2.00), SiC=3.88, 55.1% had DMFT=0: 5.6% also had poorer dental status: mean DMFT was 3.23 (vs. 1.33; p<0.001), SiC=6.69 (vs. 3.66), and only 17.1% had DMFT 0 (vs. 56.8%). CONCLUSIONS: The prevalence of dental caries and care obtained for both age groups are similar to those of other industrialised countries. When our results for 12-year-olds were compared with those of two previous surveys (1984 and 1994), a major decline in the prevalence of dental caries was observed. Being immigrant was a strong determinant in caries occurrence.     

National pathfinder survey of dental caries prevalence and treatment needs in The Gambia.

OBJECTIVE: The aim of this study was to assess dental caries status and treatment needs in The Gambia for the purpose of national planning. MATERIALS AND METHODS: 1,235 subjects were obtained with a multi-stage stratified random sampling technique. Clinical examinations were carried out using the criteria suggested in WHO Basic Methods (WHO 1987). The WHO J2 software programme was used for data analysis. RESULTS: More than half of the subjects had caries. Mean DMFT increased from 1.7 in the 7-year-old group to 8.8 in 65-99-year-olds. Mean DT peaked at 5.1 in the 30-34-year-old group before declining to 3.2 among the 65-99-year-olds. Mean filled teeth (FT) was zero in all ages. Missing teeth (MT) increased from 0.1 in 13-year-olds to 5.6 among the 65-99-year group. Mean DMFT was 2.3, 2.8, and 6.6 in 12-year-olds, 15-year-olds and 35-44-year-olds respectively. Unmet treatment need (DT/DMFT) was 90-100% in subjects below 25 years. Need for dental extraction increased from 15% to 63% in 65-99-year-olds. Between 0.3 and 2.8 teeth required extraction, and 46-79% of subjects needed conservative treatment. Dental auxiliaries should be trained to carry out extractions and fillings using the atraumatic restorative treatment (ART).     

Oral status indicators DMFT and FS-T: reflections on index selection

Oral status in a population has traditionally been described by the DMFT index (decayed, filled, and missing teeth). There seems to be contradicting and confusing evidence in the literature with regard to the usefulness of different indices. Limitations of the DMFT are recognised, and attempts have been made to develop other indices. Two indices, DMFT and FS-T (filled and sound teeth) have been selected for analysis in the present paper. The purpose of this paper is to examine the relationship between DMFT and FS-T in different populations, and to show consequences of choice of index exemplified in analytical analysis. Data stem from the Trondelag-83 and -94 studies that were follow-up studies of the Norwegian portion of the 1973 International Collaborative Study. Sunflower scatter plots and regression analyses were used to describe the variation in DMFT and FS-T in different populations. DMFT was more suitable for describing variation in populations with low levels of disease than FS-T, while FS-T was more suitable for describing variation in populations with high levels of disease. It may be concluded that both DMFT and FS-T should be presented when describing oral status in a population. However, choice of index depends first of all on the purpose of the investigation. If there are theoretical reasons to prefer one index instead of the other, the superiority of the alternative index in terms of variation must be disregarded.     

Coronal and root caries in Southern Chinese adults.

Southern China is the most prosperous part of China, but information useful for oral care planning is very limited. A large-scale epidemiological survey was conducted in 1996-97. The objectives of this report were to describe the coronal and root caries of the adult Southern Chinese and to analyze the influence of selected demographic and socio-economic factors on the disease pattern. A total sample of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds from 8 urban and 8 rural survey sites in Guangdong Province participated in an oral health interview and underwent clinical examination. World Health Organization examination procedures and diagnostic criteria were used. The weighted mean DMFT scores of the middle-aged and the elderly subjects were 4.8 and 16.1, respectively. People living in rural areas had a higher DMFT score than those living in urban areas (4.9 vs. 4.3 in the 35- to 44-year-olds and 16.5 vs. 14.7 in the 65- to 74-year-olds). In both age groups, MT was the major component of the DMFT score. Analysis of covariance showed that women and those who were economically less well off had higher DMFT scores in both age groups. The weighted prevalence rates of decayed/filled roots were 12% and 37%, with a mean of 0.2 and 0.7 teeth affected, in the middle-aged and the elderly, respectively. In conclusion, socio-economic factors had a considerable effect on the dental caries status of adults in Southern China.     

Oral health behaviour of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To assess the level of dental knowledge and attitudes among 12 year-old children and 35-44 year-olds in Burkina Faso; to evaluate the pattern of oral health behaviour among these cohorts in relation to location, gender and social characteristics and; to evaluate the relative effect of social-behavioural risk factors on caries experience. DESIGN: Across sectional study including urban and rural subgroups of population. Sample and methods: Multistage cluster sampling of households in urban areas; in rural areas random samples of participants were based on the recent population census. The final study population covered two age groups: 12 years (n = 505) and 35-44 years (n = 493). RESULTS: For both children and adults, levels of oral health knowledge, attitudes and self-care were low; 36% of 12-year-olds and 57% of 35-44-year-olds carried out toothcleaning on a daily basis. Pain and discomfort from teeth were common while dental visits were infrequent. Tooth cleaning was mostly performed by use of chewsticks. Use of toothpaste was rare, particularly fluoridated toothpaste was seldom; 9% of 12-year-olds and 18% of 35-44-year-olds reported use of fluoride toothpaste. Significant differences were found in oral health knowledge, attitudes and practices according to location and gender. At age 12, important factors of high caries experience were location (urban), and consumption of soft drinks and fresh fruits. In 35-44-year-olds, gender (female), high education level, dental visit and occupation (government employee) were the significant factors of high dental caries experience whereas adults using traditional chewing sticks had lower DMFT. CONCLUSIONS: Health authorities should strengthen the implementation of oral disease prevention and health promotion programmes rather than traditional curative care. Community-oriented essential care and affordable fluoride toothpaste should be encouraged.     

The possibility of previous epidemiological data to serve as baseline for future national oral health surveys--a study in Vietnam

AIM: The purpose of this paper is to review the most recent epidemiological data (1985-2000) on dental caries and periodontal diseases in Vietnam in an attempt to obtain a 'baseline' for future national oral health surveys. METHODS: Studies on periodontal diseases and caries were included when CPITN and WHO caries criteria had been applied and when the sample size was at least n = 200 for each age group. RESULTS: Almost all subjects had calculus. The median number of sextants with calculus in the 15-19-year- and in the 35-44-year-olds was 4.2 and 5.0, respectively. Only 2-7% of the 35-44-year-olds had one or more deep periodontal pockets. The estimated DMFT of the 12-, 15- and 35-44-year-olds was 1.8, 2.0 and 5.4, respectively, in the years around 1990. CONCLUSION: This review shows that (often neglected) epidemiological studies from the past on caries and periodontal diseases can contain comprehensive data sets that provide an estimate of the past oral health status which may serve as a baseline for future national surveys.     

Reasons for the caries decline in Slovenia

In 1987, 1993 and 1998, nationwide surveys on the prevalence of dental caries were carried out in Slovenia. Sampling and examinations were performed according to WHO standards. The age groups 6, 12, 15, 18, 35-44 and 65 years or older were studied. In each age group, 200 persons or more were examined on each occasion. The results showed that the proportion of caries-free children and adolescents increased considerably over the 12-year period between the first and the last survey (from 6% to 40% for 12-year-olds). In the same period, the mean DMFT values decreased as follows: from 5.1 to 1.8 for 12-year-olds, from 10.2 to 4.3 for 15-year-olds, from 12.9 to 7.0 for 18-years-olds, from 20.5 to 14.7 for 35-44-year-olds, and from 27.0 to 22.5 for subjects aged 65 years or more. The notable improvement of dental health can be explained by the preventive programmes in operation in various periods. The most recent decline was most likely due to supervised brushing (with concentrated fluoride gel) taking place some 16-18 times a year in primary schools attended by children aged 7-15 years, improved oral hygiene, and a comprehensive programme of applying fissure sealants, particularly on first molars.     

Dental caries trends among indigenous and non-indigenous Australian children

OBJECTIVE: To examine trends in dental caries among indigenous and non-indigenous children in an Australian territory. BASIC RESEARCH DESIGN: Routinely-collected data from a random selection of 6- and 12-year-old indigenous and non-indigenous children enrolled in the Northern Territory School Dental Service from 1989-2000 were obtained. The association of indigenous status with caries prevalence (percent dmft or DMFT>0 and percent dmft>3 or DMFT>1), caries severity (mean dmft or DMFT) and treatment need (percent d/dmft or D/DMFT) was examined. RESULTS: Results were obtained for 10,687 6- and 12-year old indigenous children and 21,777 6- and 12-year-old non-indigenous children from 1989-2000. Across all years, indigenous 6-year-olds had higher caries prevalence in the deciduous dentition, greater mean dmft and percent d/dmft, and indigenous 12-year-olds had greater percent D/DMFT than their non-indigenous counterparts (p<0.05). From 1996-2000 the mean dmft and percent d/dmft for indigenous 6-year-olds and mean DMFT and percent D/DMFT for indigenous 12-year-olds increased, yet remained relatively constant for their non-indigenous counterparts (p<0.05). From 1997-2000, the percent dmft>3 for 6-year-old indigenous children was more than double that of non-indigenous children, while across the period 1994-2000, indigenous 6-year-old mean dmft was more than double that of their non-indigenous counterparts (p<0.05). CONCLUSIONS: Indigenous children in our study experienced consistently poorer oral health than non-indigenous children. The severity of dental caries among indigenous children, particularly in the deciduous dentition, appears to be increasing while that of non-indigenous children has remained constant. Our findings suggest that indigenous children carry a disproportionate amount of the dental caries burden among Northern Territory 6- and 12-year-olds.     

A review of the oral health status in Syria

AIM: To estimate the prevalence and severity of dental caries and periodontal diseases in Syria and to determine possible secular changes in the last two decades. METHODS: Epidemiological studies performed between 1980-1999, using the WHO criteria for dental caries and the CPITN criteria for periodontal diseases in Syria were retrieved and reviewed. RESULTS: The caries experience of 5-year-old children was high (dmft of 4.7-5.2). The estimated DMFT score of 12-year-old Syrian children was 1.9-2.3. A secular change of the caries experience in the last two decades was not apparent. The amount of untreated caries lesions was high and had not changed substantially in the last two decades. The D component comprised 72-90% of the DMFT of 12-15-year-old children and 26-30% of the DMFT of 35-44-year-old Syrians. The majority of 15-24-year-olds, and more than 80% of the 35-44-year-olds had calculus. Despite the widespread and chronic existence of calculus, only 3-11% of the 35-44-year-old persons had one or more deep periodontal pockets. CONCLUSION: The caries experience in Syria is moderately low and does not seem to have changed in the last two decades. The increased output of graduate dentists in the last decade has not changed the large amount of untreated caries lesions. In Syria, where the prevalence of unmet (caries) treatment needs is high, regular removal of calculus (scaling) for the sake of preventing periodontal pockets should not have a high priority in the oral health services.     

Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults

PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on 5,532 adults from rural and urban cluster samples. DMFT was related to age, gender, and residence. The pattern of tooth loss within dental arches was mapped, and the prevalence of shortened dental arches was estimated. RESULTS: Mean DMFT scores increased gradually from 1.8 (20- to 29-year-olds) to 3.8 (50- to 59-year-olds). A steep increase was observed in the > or = 60-year-olds (DMFT 8.1). "Missing" was the dominant component of DMFT. The mean number of present teeth ranged from 27 in the youngest to 20 in the oldest age group. Under 60 years of age, DMFT was significantly higher for women than for men. No differences were found between residence categories. Molars were more frequently decayed, missing, and mobile than premolars. Of all subjects, 41% had complete dental arches, 44% had interruptions (of these, 73% were in posterior regions only), and 15% had shortened dental arches; 0.5% were edentulous. Of the subjects with shortened dental arches, about 65% had at minimum three pairs of occluding premolars. CONCLUSION: An initial low DMFT rate increased after the age of 60 years. Molars had the highest risk of dental decay and were most frequently absent. Shortened dental arches develop as a consequence of the pattern of tooth decay and tooth loss, although interruptions were frequently seen in the posterior regions.     

Dental fear and adult oral health in Australia

Abstract– Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three‐stage stratified clustered sample of the Australian adult population completed a computer‐assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.