Methods A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined and dmft and its components were recorded. A postal questionnaire was sent to parents of participating children to identify whether children attended the dentist on a regular asymptomatic basis or only when experiencing problems. Additionally parents were asked to judge whether they and their child were anxious about dental treatment. The socio-economic status of the family was measured using the Townsend Material Deprivation Index of the electoral ward in which they resided. The bivariate relationships between anxiety and reported attendance, caries experience, past extraction and restoration history were assessed using chi-square and t-tests. Multiple logistic regression analyses were used to identify predictors for dental anxiety.

Results A total of 1,745 children received both a clinical examination and a questionnaire and 1,437 parents responded, a response rate of 82.3%. One in ten parents (10.8%) judged their child to be dentally anxious. Anxious children had significantly (p<0.001) more caries experience (dmft 2.58 vs 1.12). Multiple logistic regression analyses confirmed that anxious children were more likely to be irregular attenders (OR 3.33, 95% CI 2.22, 5.00), have anxious parents (OR 1.60, 95% CI 1.09, 2.36), and to have undergone dental extraction in the past (OR 3.50, 95% CI 2.10, 5.85), after controlling for gender and socioeconomic status. A past history of restoration was not a significant predictor of anxiety after controlling for other factors.

Conclusions Dental anxiety is a fairly common condition in 5-year-old children in the North West of England. It is closely associated with a symptomatic, irregular attendance pattern, a history of extraction and having a dentally anxious parent. The cause and effect dynamics of these relationships need to be determined.