Objectives: The aims were to compare prevalence of high dental anxiety (DA) in 2000, 2011 and 2023, to compare the age- and sex-specific levels of DA, and to study if total, anticipatory, and treatment-related DA have an independent association with the non-habitual use of oral health care considering age, sex, education, current perceived treatment need, and reported barriers to use of oral health in nationally representative samples of adult Finns (n = 1950).

Methods: DA was assessed with a single question (n = 1770) for prevalence and with the Modified Dental Anxiety Scale (MDAS) (n = 1739) for DA levels described as means, medians, standard errors (SE), interquartile ranges, and 95% confidence intervals (CI). Multivariable logistic regression analyses were used to assess the independent effect of total, anticipatory, and treatment-related DA on habitual use of oral health care (regular = habitual, for toothache or other problems = non-habitual) adjusted for age, sex, level of attained education, current perceived treatment need, and barriers to using oral health care (care costs and long queues).

Results: Among women, the prevalence of high DA decreased from 2000 to 2011, but the decrease did not continue between 2011 and 2023. Among men, the prevalence of high DA decreased between 2000 and 2023. The mean MDAS (SE) for women was 10.1 (0.1) and for men 8.4 (0.1). Total, anticipatory, and treatment-related dental DA had an independent association with non-habitual use of oral health services.

Conclusions: DA as an independent barrier to oral health care can prevent habitual care utilization, potentially leading to poor oral health.