Psychometric properties of the Revised Dental Beliefs Survey

OBJECTIVES: The objectives of this pair of studies were to examine the internal reliability, test-retest reliability, and construct validity of the Revised Dental Beliefs Survey. METHODS: A total of 108 college students completed two questionnaires containing the Revised Dental Beliefs Survey, as well as the Revised Iowa Dental Control Index, and Desirability of Control scales. As part of another experiment, 141 study participants with dental injection phobia completed the Revised Dental Beliefs Survey and the Dental Anxiety Scale. RESULTS: Both the internal and test-retest reliabilities of the Revised Dental Beliefs Survey were high. The measure demonstrated good convergent and discriminant validities. CONCLUSION: The Revised Dental Beliefs Survey is well-suited for use with clinical and nonclinical populations, in which a stable and valid measure of perceptions of the dental situation is desired.     

Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population

OBJECTIVES: Fear of dentistry is a common obstacle to obtaining dental care in Turkey. The aim of this study was to assess the reliability, validity and psychometric characteristics of the Turkish translation of the Modified Dental Anxiety Scale (MDAS) and compare it to the Dental Fear Survey (DFS) scores obtained in the same population. METHODS: The Turkish translated version of the MDAS was administered to 115 dental patients; 21 subjects who suffered from dental phobia, requiring general anesthesia for dental procedures, and 94 who did not have dental anxiety, in addition to 442 subjects from the general population. RESULTS: The Turkish translated version of the MDAS was internally consistent and reproducible. The patients with dentist phobia had the highest score. The Turkish MDAS correlated with the DFS (r = 0.80, P < 0.001). The MDAS scale correlated inversely (r = -0.14, P < 0.005) with level of education; however, it did not correlate with economic status. Women scored higher than men on the scale (mean = 12.3, SD = 5.2 vs. mean = 10.9, SD = 4.5, P < 0.005). At a cut-off point > or = 15, sensitivity was 0.80, specificity 0.74, positive predictive value 0.41 and negative predictive value 0.94. CONCLUSION: Although the specificity values were low, the Turkish MDAS demonstrated acceptable sensitivity, positive and negative predictive values. Thus, high reliability and validity of the MDAS supports its cross-cultural validity and indicated that it may be a valuable tool in quantifying fear of dentistry among Turks.     

Validity and Reliability of the Vietnamese Version of the Dental Fear Survey

ObjectivesThe use of questionnaires to assess patients’ dental fear is critical to dental research and practice. As one of the most well-established tools in this field, the Dental Fear Survey (DFS) was translated into Vietnamese (V-DFS) and employed in previous studies. However, its validity and reliability have not been reported. This study aimed to determine the validity and reliability of V-DFS in adults.MethodsThe DFS was translated to Vietnamese in accordance with the “Guideline for the Process of Cross-cultural Adaptation of Self-reported Measures” to create the V-DFS. Next, 414 students at Pham Ngoc Thach University of Medicine completed the V-DFS to examine its validity and reliability. The factorial validity of V-DFS was assessed using exploratory factor analysis (EFA) and structural equation modeling (SEM). The internal consistency and test-retest reliability of the V-DFS were assessed using Cronbach's alpha (α), intraclass correlation coefficient (ICC), and Spearman's rank-order correlation coefficient (r_s).ResultsThe rotated component matrix of the EFA revealed 3 factors: specific stimuli, anticipatory fear and avoidance, and physiologic arousal. The statistical indices of the best-fitting V-DFS model in SEM analysis satisfied the cutoff values. Cronbach's α ranged from .82 to .94 for the 3 factors. The ICC and r_s of the whole questionnaire were .86 and .86, respectively.ConclusionsDFS was successfully translated into Vietnamese with good validity and reliability. Further research should be conducted to examine its validity in various populations and to improve its characteristics.     

Psychometric properties of Spanish-language adult dental fear measures

Background  

It would be useful to have psychometrically-sound measures of dental fear for Hispanics, who comprise the largest ethnic minority in the United States. We report on the psychometric properties of Spanish-language versions of two common adult measures of dental fear (Modified Dental Anxiety Scale, MDAS; Dental Fear Survey, DFS), as well as a measure of fear of dental injections (Needle Survey, NS).     

Dental anxiety among adults in Turkey

AIM: This aim of this study was to investigate the prevalence of dental anxiety and related factors in a Turkish population. METHODS AND MATERIALS: The Turkish translation of the Dental Fear Scale (DFS) and the Modified Dental Anxiety Scale (MDAS) were administered to 115 dental patients consisting of 21 subjects who had dental phobia and of 94 patients who did not. The scales were also administered to a non-clinical general population (N=183). RESULTS: The Turkish version of the DFS was internally consistent and reproducible. The scale had strong correlations (r=0.80, p<0.001 ) with the MDAS. Female participants scored higher (45.2+/-18.1) on the scale than men (38.2+/-15.7). The DFS had a negative correlation (r=-0.25, p<0.001) with education level. There was a statistically significant difference between dental phobics and the remaining groups on the DFS total score. At a cut-off point 55, the sensitivity of the scale was 0.80, specificity 0.80, positive predictive value 0.48, and negative predictive value 0.95. Thirty-nine subjects (21.3%) in the general population had total scores above this cut-off point. CONCLUSION: Dental fear is common in clinical and non-clinical settings in Turkey. The good psychometric characteristics of the DFS among Turkish participants supports its cross-cultural validity.     

Additional psychometric data for the Spanish Modified Dental Anxiety Scale,and psychometric data for a Spanish version of the Revised Dental Beliefs Survey

Background  

Hispanics comprise the largest ethnic minority group in the United States. Previous work with the Spanish Modified Dental Anxiety Scale (MDAS) yielded good validity, but lower test-retest reliability. We report the performance of the Spanish MDAS in a new sample, as well as the performance of the Spanish Revised Dental Beliefs Survey (R-DBS).     

The Dental Neglect Scale in adolescents

Background  

Dental neglect has been found to be related to poor oral health, a tendency not to have had routine check-ups, and a longer period of time since the last dental appointment in samples of children and adults. The Dental Neglect Scale (DNS) has been found to be a valid measure of dental neglect in samples of children and adults, and may be valid for adolescents as well. We administered the DNS to a sample of adolescents and report on the relationships between the DNS and oral health status, whether or not the adolescent has been to the dentist recently for routine check-ups, and whether or not the adolescent currently goes to a dentist. We also report the internal and test-retest reliabilities of the DNS in this sample, as well as the results of an exploratory factor analysis.     

Further evidence for the reliability and validity of the Modified Dental Anxiety Scale

Aim: To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. Setting: Dental admission clinics. Design: Consecutive sampling, cross‐sectional survey. Participants: Patients (n=800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). Methods: Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. Measures: Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. Results: Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. Conclusion: Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.     

Dental erosion prevalence and associated risk indicators among preschool children in Athens, Greece

Objectives

The aims of the study were to investigate dental erosion prevalence, distribution and severity in Greek preschool children attending public kindergartens in the prefecture of Attica, Greece and to determine the effect of dental caries, oral hygiene level, socio-economic factors, dental behavior, erosion related medication and chronic illness.

Material and methods

A random and stratified sample of 605 Greek preschool children was clinically examined for dental erosion using the Basic Erosive Wear Examination Index (ΒΕWE). Dental caries (dmfs) and Simplified Debris Index were also recorded. The data concerning possible risk indicators were derived by a questionnaire. Zero-inflated Poisson regression was generated to test the predictive effects of the independent variables on dental erosion.

Results

The prevalence of dental erosion was 78.8 %, and the mean and SE of BEWE index was 3.64?±?0.15. High monthly family income was positively related to ΒΕWE cumulative scores [RR?=?1.204 (1.016–1.427)], while high maternal education level [RR?=?0.872 (0.771–0.986)] and poor oral hygiene level [DI-s, RR?=?0.584 (0.450–0.756)] showed a negative association.

Conclusions

Dental erosion is a common oral disease in Greek preschool children in Attica, related to oral hygiene and socio-economic factors.

Clinical relevance

Programs aimed at erosion prevention should begin at an early age for all children.     

The Level of Anxiety and Pain Perception of Endodontic Patients

Objectives

to compare the level of anxiety reported by patients and assessed by dentists. Also, the expected and actual pain during the treatment perceived by the patient and dentist were assessed.

Methods

sixty six endodontic patients filled in two questionnaires, prior to and after the treatment, so did their therapists. The first set of questions for patients was regarding demographics, the frequency of dental visits, the level of anxiety and expectations about the level of pain. Before the treatment, dentists estimated the level of patients'' anxiety and the expected intensity of pain. After the treatment, the patients evaluated the level of experienced pain and dentists'' empathy during the treatment, while dentists reassessed the intensity of patients'' pain.The data were statistically analysed by t-test for paired samples and by Spearmans''s Rho correlation coefficient at level of significance set at 0.05.

Results

Patients'' expectation of pain intensity was higher than the actual pain during the treatment (t-test=3.540, p=0.001). There was no difference in the level of pain which dentists expected and their perception of pain during the procedure. There was a statistically significant correlation between the patients'' level of anxiety and recognition of it by dentists (Spearman Rho=0.460, p<0.001). A higher level of anxiety increased the expected intensity of pain (Spearman Rho=0.401, p=0.001). Actual intensity of pain was not significantly associated with dental anxiety (Spearman Rho=0.080, p=0.524).

Conclusion

Since the level of dental anxiety was associated with the increased intensity of expected pain, a vicious cycle of pain and anxiety may be terminated by giving positive information to the patient before and during endodontic procedures.     

138例牙科种植术前患者焦虑水平与STAI量表相关性分析

目的:探讨种植患者术前焦虑症状况与状态-特质焦虑量表(state-trait anxiety inventory,STAI)的相关性.方法:选择2018年5月-2021年5月间上海市浦东新区人民医院口腔科收治的138例种植修复患者作为研究对象,采用改良版Croa牙科焦虑量表(modified dental anxiet...     

Psychometric properties of the modified dental anxiety scale: an independent replication

AIM: To estimate the internal consistency, test-retest reliability, discriminant and concurrent validity of the Modified Dental Anxiety Scale (MDAS). METHOD: Survey of a cohort of 135 dental patients in three equal groups (non-anxious; treated anxious; highly anxious). The average age of the total sample was 39.2 years (SD = 13.21), 101 patients (75%) were female. All patients were asked to complete the MDAS, together with the brief form (six items) of the Speilberger Trait Anxiety Inventory (STAI). Thirty-three participants completed the MDAS on a second occasion 2-3 months after the first testing session. FINDINGS: The MDAS is highly internally consistent (Cronbach alpha = 0.93) and shows good reliability over time (Intra-class correlation coefficient = 0.93). The MDAS was found to discriminate between the three groups of participants defined by self-reported anxiety level, and correlates highly with the Speilberger Trait Anxiety Inventory. CONCLUSIONS: The MDAS is a highly consistent and reliable measure which has good discriminant and concurrent validity.     

The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age

Background  

The Modified Dental Anxiety Scale (MDAS) is a brief, self-complete questionnaire consisting of five questions and summed together to produce a total score ranging from 5 to 25. It has reasonable psychometric properties, low instrumental effects and can be integrated into everyday dental practice as a clinical aid and screen for dental anxiety. The objectives were to (i) produce confirmatory evidence of reliability and validity for the MDAS, (ii) provide up-to-date UK representative norms for the general public to enable clinicians to compare their patients' scores, (iii) to determine the nature of the relationship between dental anxiety and age.     

A randomised control trial of the effectiveness of personalised letters sent subsequent to school dental inspections in increasing registration in unregistered children

Background

The Child Perceptions Questionnaires (CPQ_8–10 and CPQ_11–14) are indicators of child oral health-related quality of life. The aim of this study was to assess the validity and reliability of the self-applied CPQ_8–10 and CPQ_11–14 in Brazilian children, after translations and cultural adaptations in the Brazilian Portuguese language.

Methods

Schoolchildren were recruited from general populations for pre-testing (n = 80), validity (n = 210), and test-retest reliability (n = 50) studies. They were also examined for dental caries, gingivitis, fluorosis, and malocclusion.

Results

Children with greater dental caries experience in primary dentition had higher impacts on CPQ domains. Girls had higher scores for CPQ_8–10 domains than boys. Mean CPQ_11–14 scores were highest for 11-year-old children and lowest for 14-year-old children. Construct validity was supported by significant associations between the CPQ_8–10 and CPQ_11–14 scores and the global rating of oral health (r = 0.38, r = 0.43) and overall well-being (r = 0.39, r = 0.60), respectively. The Cronbach's alpha was 0.95 for both questionnaires. The test-retest reliabilities of the overall CPQ_8–10 and CPQ_11–14 scores were both excellent (ICC = 0.96, ICC = 0.92).

Conclusion

The Brazilian Portuguese version of CPQ_8–10 and CPQ_11–14 was valuable and reliable for use in the Brazilian child population, although discriminant validity was sporadic due to the fact that impacts are mediated by others factors, such personal, social, and environmental variables.     

Psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS)

Background

Oral disorders can have a negative impact on the functional, social and psychological wellbeing of young children and their families and cause pain/discomfort for the child. Oral health-related quality of life (OHRQoL) has emerged as an important health outcome in clinical trials and healthcare research. The Early Childhood Oral Health Impact Scale (ECOHIS) is a proxy measure of children's OHRQoL designed to assess the negative impact of oral disorders on the quality of life of preschool children. The objective of this study was to evaluate the psychometric properties of the Brazilian version of the ECOHIS (B-ECOHIS).

Methods

This investigation was carried out in preliminary and field studies. The preliminary study comprised a cross-sectional study carried out in the city of Petropolis, Brazil. A sample of 150 children from two to five years of age was recruited at a public hospital. In the field study, an epidemiological survey was carried out in public and private preschools of Belo Horizonte, Brazil. The B-ECOHIS was answered by 1643 parents/caregivers of five-year-old male and female preschool children. In both phases, oral examinations were performed by a single previously calibrated dentist. Reliability was determined through test-retest reliability and internal consistency. Validity was determined through convergent and discriminant validities. The correlation between the scores obtained on the child and family impact sections was assessed.

Results

In the preliminary (P) and field (F) study, test-retest reliability correlation values were 0.98 and 0.99 for the child impact section and 0.97 and 0.99 for the family impact section, respectively. The B-ECOHIS demonstrated internal consistency: child impact section (P: α = 0.74; F: α = 0.80) and family impact section (P: α = 0.59; F: α = 0.76). The correlation between the scores obtained on the child and family impact sections was statistically significant (P: r_s = 0.54; F: r_s = 0.62; p ≤ 0.001). In both phases of the study, B-ECOHIS scores were significantly associated with the decayed, missing and filled teeth index, decayed teeth and discolored upper anterior teeth (p < 0.05).

Conclusion

The B-ECOHIS proved reliable and valid for assessing the negative impact of oral disorders on the quality of life of preschool children.     

What is the most fearful intervention in ambulatory oral surgery? Analysis of an outpatient clinic

The aim of this study was to evaluate the levels of fear and anxiety in patients undergoing different types of minor oral surgery procedures by using conventional rating scales adjusted to the population characteristics. A demographic form and translated versions of the Modified Dental Anxiety Scale (MDAS) and Dental Fear Survey (DFS) were completed by 500 patients having hard or soft tissue pathologies, third molar removal, implant placement, tooth extraction procedures and 200 non-clinical participants. MDAS and DFS were highly correlated (r=0.79; P<0.05). The structural properties of the MDAS were similar to the original, but the DFS required substantive changes to achieve comparable measurement properties. Anxiety levels decreased with age and were greater in females, those with higher education and following a previous unpleasant experience (P<0.05 for all). The third molar group scored higher than most of the surgical categories in both questionnaires (P<0.05 for each). DFS showed they tended to avoid surgical procedures and were more susceptible to environmental and chair-side effects (P<0.05 for all). Regarding oral surgery, third molar patients should be targeted to increase overall comfort of the treatment. Assessments should be adjusted to cultural differences.     

Dental anxiety among young adolescent patients in Israel

Aim. To evaluate adolescents’ dental anxiety using self‐reported questionnaires previously given to adults. Sample and method. One hundred and four patients (42 boys, 62 girls) aged 12–18 years who attended their paediatric dentist completed a questionnaire in the waiting room. The survey consisted of three sections: sociodemographic information for the children, a dental anxiety scale (DAS), and a dental fear survey (DFS). Results. The scores of the girls were higher than the boys in every DAS item as well as in the total score. Girls showed higher DFS scores than boys in most items. The most anxiety‐provoking stimuli were feeling and seeing the needle. In the most anxiety provoking stimuli, among the boys who reported higher DFS scores (categories 3, 4, 5), the DAS scores were higher than the scores of the girls. As the stimulus became less anxiety‐provoking, such as sitting in the dental chair, the DAS scores of the girls in these categories were higher than boys. Significantly more girls’ responses were in categories 3, 4 and 5 in the items dealing with the needle and the drill, while no significant difference was observed among the boys and girls regarding sitting in the dental chair. Conclusions. It is concluded that individual personality traits may be the final factor to indicate those who will eventually develop higher dental anxiety, and those who will not. The difference could be also in the conditioning process and learned responses (male and female education) that these individuals have experienced in life.     

Patients' Expectations Before and Evaluation After Dental Implant Therapy

Background: Patients' expectations may influence their satisfaction with implant treatment, but there is a paucity of reports comparing patient expectations and their posttreatment satisfaction. Purpose: The aim was to compare patients' expectations before with their satisfaction regarding function and esthetics after dental implant therapy. Materials and Methods: Fifty volunteers (49 years ± 11.45) answered a questionnaire about influencing variables and underwent an initial examination followed by implant therapy. Their expectations regarding esthetics and function were verified on a visual analogue scale (VAS) before treatment. The VAS was also used for posttreatment completion rating. Results: The average ratings for esthetic and functional expectations were 5.0 ± 2.6 and 5.0 ± 3.0; the posttreatment completion ratings were 9.1 ± 1.1 and 9.0 ± 1.7, respectively. The posttreatment completion ratings significantly exceeded expectations (p < .001, Wilcoxon test). Positive correlations were found between expectations and posttreatment completion ratings for esthetics (Spearman's rho = 0.496, p < .001) and function (Spearman's rho = 0.706, p < .001). An inverse correlation was found between age and functional expectations (Spearman's rho = ?0.313, p = .027). Conclusions: Patients' posttreatment completion ratings significantly exceeded their initial expectations. Expectations and posttreatment completion ratings were irrespective of smoking habits, location in the jaw, sex, or educational level.     

Do dental anxiety questionnaires raise anxiety in dentally anxious adult patients? A two-wave panel study.

OBJECTIVE: To test whether or not dentally anxious patients attending the dentist for an appointment become more anxious when completing a dental anxiety questionnaire. BASIC RESEARCH DESIGN: Patients were initially screened to include only those who were dentally anxious. A pre- and post-test was planned with the completion of the Modified Dental Anxiety Scale (MDAS) questionnaire as the intervention. CLINICAL SETTING: Two dental access centres in the North West of England. PARTICIPANTS: Initially, 583 patients were screened. Of these, 182 (31%) were found to be dentally anxious and were recruited into the study. MAIN OUTCOME MEASURES: State-Trait Anxiety Inventory Scale Short Form. RESULTS: State anxiety did not change with the completion of the MDAS questionnaire in either designated dental phobics (MDAS >or=19) or those classified as non-phobics (MDAS <19). CONCLUSIONS: The MDAS can be used to assess dental anxiety without raising anxiety in patients with or without self-reported dental phobia.     

Emergency dental clinic patients in South Devon, their anxiety levels, expressed demand for treatment under sedation and suitability for management under sedation.

OBJECTIVE: To assess the anxiety levels of patients attending two salaried dental service emergency clinics, their expressed demand for treatment under sedation, and their medical suitability for dental sedation. DESIGN: A questionnaire survey, incorporating the Modified Dental Anxiety Scale (MDAS) and assessment of American Society of Anesthesiologists' (ASA) physical status classification, of all adult patients attending two emergency dental clinics in Torquay and Newton Abbot. RESULTS: 513 patients returned questionnaires. Only five declined to take part in the study. The mean MDAS for patients attending the two emergency dental clinics was 14.09 (SD 6.04) and 41.9% of patients were classified as dentally anxious (MDAS >15). A preference for treatment under sedation was expressed by 56.3%, of all patients, of whom 50.5% were classified as ASA 1 (without health problems) and would have been suitable for sedation in primary dental care. CONCLUSIONS: The reported dental anxiety levels of patients attending the two emergency dental clinics were found to be much higher than those found by previous studies in general dental practice and at dental school emergency clinics. There was a high expressed demand for treatment under sedation. Further studies are needed to assess the levels of dental anxiety seen at other dental emergency clinics and a health needs assessment to determine need as opposed to expressed demand.