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Manan NM, Musa S, Nor MMD, Saari CZ, Al-Namankany A. The Abeer Children Dental Anxiety Scale (ACDAS) cross-cultural adaptation and validity of self-report measures in the Malaysian Children Context (MY-ACDAS). Int J Paediatr Dent 2024; 34:267-276. [PMID: 37985445 DOI: 10.1111/ipd.13132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/11/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND The Abeer Children Dental Anxiety Scale (ACDAS) source language was developed and validated in an English-speaking country in the UK to measure dental anxiety among children. The ACDAS also included the child's cognitive assessment, as well as feedback from the parent or the legal guardian and a dental health professional (DHP). This is the first study to validate the application of the ACDAS in Malay or Bahasa Melayu for children aged 6-16 years. AIM To assess the Malay-translated version of the ACDAS, postadaptation into the local context and validation by the content and construct experts. DESIGN The English ACDAS was translated into Malay first through forward translation and then through backward translation. The prefinal translated version of the instrument was designed, with the participation of 61 children and 61 parents or legal guardians. Subsequently, a final cross-cultural adaptation of the instrument was then made for another group of participants and evaluated for validity and test-retest reliability among 144 children and 144 parents or legal guardians participating in the self-report feedback process at the Paediatric Dental Clinic, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia. The cross-cultural adaptation of the instrument considered translating to Malaysian national language and adapting to its culture. RESULTS The Malay-translated ACDAS consisted of 19 items. The translated version of Malaysian-ACDAS (MY-ACDAS) achieved an acceptable agreement between six expert committee members with an internal consistency (Cronbach's alpha value, αconsistency) of 0.839. The test-retest reliability results of all participants support semantic and conceptual equivalence as an accepted construct validity between the children, parents and DHPs across the multicultural Malaysian population. CONCLUSION The MY-ACDAS is a valid and reliable scale for measuring dental anxiety among Malaysian children.
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Affiliation(s)
- Nor Malina Manan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sabri Musa
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mariani M D Nor
- Department of Postgraduate, Faculty of Education, Languages and Psychology, SEGI University and Colleges, Petaling Jaya, Selangor, Malaysia
| | - Che Zarrina Saari
- Department of Aqidah and Islamic Thought, Academy of Islamic Studies, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Abeer Al-Namankany
- Paediatric Dentistry Department, Taibah University, Al Madinah Al Munawara, Saudi Arabia
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Barbosa TDS, Azevedo MS, Vidal GL, D’Almeida PVB, Bruzamolin CD, Costa LR, Costa VPPD, Goettems ML. Translation and Cultural Adaptation of the Modified Child Dental Anxiety Scale – Faces (MCDASf) into Brazilian Portuguese. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Turkish version of the faces version of the Modified Child Dental Anxiety Scale (MCDAS f): translation, reliability, and validity. Clin Oral Investig 2021; 26:2031-2042. [PMID: 34581886 DOI: 10.1007/s00784-021-04184-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To cross-culturally adapt of MCDASf into Turkish and to evaluate reliability and validity of the Turkish version of MCDASf using explorative factor analysis (EFA), confirmatory factor analysis (CFA), and receiver operating characteristic (ROC) analysis to form a less time consuming and easy to understand tool for measuring dental anxiety. MATERIALS AND METHODS A total of 300 children (174 females, 126 males) aged 6-12 years who were recruited at the Department of Paediatric Dentistry in RTEU at the first visit participated in the present study. For the internal consistency reliability, Cronbach's alpha was calculated. Intraclass correlation coefficients (ICCs) were calculated for test-retest reliability (n=67). Construct validity was determined by comparing with the Venham Picture Test (VPT). The factor structure was examined using EFA. CFA was used for dimensionality. The cut-off points of the Turkish version of MCDASf were plotted using a ROC curve. RESULTS The Turkish version of MCDASf showed high internal consistency (0.703) and an excellent ICC value (0.827). Good correlations were found between the global scores of MCDASf and VPT (r=0.632). Three factors were identified from EFA and verified with CFA. Discriminant validity was supported by high scores of females and younger children (p<0.05). The cut-off point was assigned as >24.50. The area under the ROC curve (AUC) was 0.921 (95% CI: 0.873-0.969). CONCLUSIONS The Turkish version of the MCDASf is a reliable and valid scale that satisfied psychometric properties. CLINICAL RELEVANCE The Turkish version of MCDASf is a usable tool for the measurement of dental anxiety among Turkish speaking children.
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AlGharebi S, Al-Halabi M, Kowash M, Khamis AH, Hussein I. Children's dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital. Eur Arch Paediatr Dent 2021; 22:29-40. [PMID: 32170653 DOI: 10.1007/s40368-020-00517-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 02/27/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Child dental anxiety (CDA) and uncooperative dental behaviour are common. We aimed to assess the prevalence of CDA (self- and proxy- reported) in the United Arab Emirates (UAE) children related to their dental behaviour. METHODS Data were collected from 312 questionnaires obtained from 156 parent/child (mean age 9.95 ± 2.17 years) pairs attending a postgraduate dental hospital. Demographics, self/proxy- reported CDA scores via a six-question, five-point Likert scale, of the Modified CDA Scale-faces version (MCDAS-f: where ≥ 19 was severe CDA) and Frankl Behaviour Rating Scale (FBRS) scores were compared and analysed. Chi-square test, Pearson's correlation, Kappa- coefficient, one-way ANOVA and independent t test statistical analysis were used (p < 0.05). RESULTS The prevalence of self and proxy severe CDA was 22.4% (n = 35) and 33.3% (n = 52) respectively, with 9% (n = 14) being dentally- uncooperative. In both groups, extractions caused the highest CDA followed by injections and fillings (p < 0.001). The mean scores for self-reported/proxy-reported CDA were 15.02 (± 4.90)/15.70 (± 6.07) respectively. There was a positive linear correlation between self- and proxy- reported CDA scores and a negative linear correlation between self/proxy- reported CDA scores and the FBRS (p < 0.001). Self/proxy concordance of severe anxiety/none-to-moderate- anxiety was fair (68.6%, kappa = 0.23, p = 0.003). Both self/FBRS and proxy/FBRS concordance of severe anxiety/none-to-moderate- anxiety/behaviour was fair (78.8%, kappa = 0.23, p = 0.001) and (71.8%, kappa = 0.22, p < 0.001) respectively. CONCLUSIONS Considering the limitations of the present study in a UAE child population sample, the prevalence of CDA from extractions, injections and fillings was 22.4% (self- reported) and 33% (proxy reported). There was fair agreement between child- self and parent- proxy- reported CDA. Increased CDA led to uncooperative dental behaviour.
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Affiliation(s)
- S AlGharebi
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - M Al-Halabi
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - M Kowash
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - A H Khamis
- Biostatistics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - I Hussein
- Paediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.
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GS G, George S, Anandaraj S, Sain S, Jose D, Sreenivas A, Pillai G, Mol N. Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study. Int J Clin Pediatr Dent 2021; 14:S173-S178. [PMID: 35645488 PMCID: PMC9108792 DOI: 10.5005/jp-journals-10005-2106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives and methods Children, in the age-group of 6 to 8 years, with moderate level of anxiety, (measured with M-DAS), requiring inferior alveolar nerve block (IANB) for mandibular tooth extraction were selected. Informed consent was obtained from parents. Selected children were allocated randomly into 3 groups virtual reality (VR) distraction group, audio distraction group and Tell-show-do (TSD) group. Pre- and post- distraction anxiety level of children was measured subjectively with facial image scale and objectively with pulse rate and oxygen saturation (measured with pulse oxymeter). Results There was a statistically significant decrease in pulse rate after distraction (with a p < 0.01) in all the three groups. Postdistraction pulse rate was lowest in the VR distraction group when compared to other groups. While comparing postdistraction pulse rate values in the three groups, the difference in pulse rate between TSD and VR distraction group was significant. But while comparing the pulse rate between audio distraction and TSD group (p = 0.06), and audio distraction and VR distraction group (p = 0.24) was not statistically significant. Oxygen saturation increased in all the three groups which was statistically significant (p < 0.01). There was a statistically significant difference in the postdistraction oxygen (O2) saturation levels between TSD and audio distraction groups (p < 0.05) with more O2 saturation in audio distraction group. But while comparing the audio distraction with VR group and TSD with VR group, the difference was not significant. Facial image scale (FIS) scores decreased in all the three groups (p < 0.01). Conclusion The overall results revealed by all the parameters indicate that children were most relaxed in VR group, followed by audio group and were least relaxed in TSD group during dental visits. Hence VR distraction can be considered as a useful technique for behavior management of pediatric patients during a conventional dental treatment. How to cite this article SG G, George S, S A, et al. Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(S-2):S173-S178.
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Affiliation(s)
- Greeshma GS
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Sageena George
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - S Anandaraj
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Shaniya Sain
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Deepak Jose
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Arjun Sreenivas
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - GadhaRajendran Pillai
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Noufila Mol
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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Esa R, Jamaludin M, Yusof ZYM. Impact of maternal and child dental anxiety on oral health-related quality of life of 5-6-year-old preschool children. Health Qual Life Outcomes 2020; 18:319. [PMID: 32993663 PMCID: PMC7526362 DOI: 10.1186/s12955-020-01565-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/16/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a lack of evidence with regards to the association between both maternal and child dental anxiety and the mother's perception of her child's oral health-related quality of life (COHRQoL). The aim of this study was to investigate the association of maternal and child dental anxiety with COHRQoL and the effect of demographic factors as moderators in this relationship. In addition, the association between child's dental caries experience and the COHRQoL was also assessed. METHODS A cross-sectional study was conducted involving 1150, 5-6 year-old preschool children in Selangor, Malaysia. Mothers answered a questionnaire on socio-economic status, the Malay-Modified Dental Anxiety Scale to assess maternal dental anxiety, and the Malay-Early Childhood Oral Health Impact Scale to assess COHRQoL. Child's dental anxiety was assessed using the Malay-Modified Child Dental Anxiety Scale via a face-to-face interview prior to oral examination to assess dental caries. Data were analysed using structural equation modelling to assess the relationship between maternal and child dental anxiety and COHRQoL. RESULTS Overall, complete data on 842 mother-child dyads were analysed. The mean scores of total ECOHIS, the child impacts section (CIS), and the family impacts section (FIS) were 17.7 (SD = 4.9), 12.6 (SD = 3.7), and 5.1 (SD = 1.9), respectively. The mean dental anxiety scores for mothers and children were 11.8 (SD = 4.5) and 16.9 (SD = 4.3), respectively. Maternal dental anxiety was associated with the CIS (b = 0.08, p < 0.001), the FIS (b = 0.01, p = 0.001), and the total ECOHIS (b = 0.14, p < 0.001). Maternal education level, income, urban/rural location, and kindergarten type were moderators to the relationship. In addition, there was also a significant relationship between child's dental caries experience and COHRQoL (p < 0.001). CONCLUSIONS Maternal dental anxiety and child's dental caries experience have significantly impacted the COHRQoL, the CIS, and the FIS domains. Demographic factors such as maternal education, income, urban/rural location, and kindergarten type acted as moderators that can strengthen or weaken the relationship between maternal dental anxiety and COHRQoL of 5-6-year-old preschool children.
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Affiliation(s)
- Rashidah Esa
- Department of Dental Public Health, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Jenjarom, Selangor, Malaysia.,Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.,Community Oral Health Research Group, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Marhazlinda Jamaludin
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.,Community Oral Health Research Group, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Community Oral Health Research Group, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Yon MJY, Chen KJ, Gao SS, Duangthip D, Lo ECM, Chu CH. An Introduction to Assessing Dental Fear and Anxiety in Children. Healthcare (Basel) 2020; 8:healthcare8020086. [PMID: 32260395 PMCID: PMC7348974 DOI: 10.3390/healthcare8020086] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 01/30/2023] Open
Abstract
Fear and anxiety constitute an important theme in dentistry, especially with children. Anxiety and the fear of pain during dental treatment can lead to avoidance behaviour, which contributes to perpetuating fear and anxiety of dental care. Understanding and assessing dental fear and anxiety in children is important for delivering successful dental care with high satisfaction in this age group. Among the vast assessment method options available today, self-report assessment, parental proxy assessment, observation-based assessment, and physiological assessment are the four major types for dental fear and anxiety in children. Each method has its own merits and limitations. The selection of a method should be based on the objectives, validity, and setting of the assessment. The aim of this paper is to review and discuss the assessment methods for dental fear and anxiety in children.
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Abstract
OBJECTIVES The aim of this study was to differentiate anxious from nonanxious adolescents and evaluate gender differences in anxiety with respect to previous negative dental and medical experiences. The purpose was also to evaluate a causative relationship between child medical fear and dental anxiety. STUDY DESIGN This study sampled 113 Croatian adolescents from 15 to18 years of age. Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used for the assessment of child dental anxiety regarding visits to the dentist and receiving dental treatment. A modified version of Child Medical Fear Questionnaire (CMFQ-M) was used for evaluation of child medical fear related to medical treatment and doctors in general. RESULTS AND CONCLUSION The results showed significantly higher dental anxiety (CFSS-DS) and medical fear (CMFQ-M) in adolscent girls (p<0,001) as compared to adolescent boys. A significantly strong correlation between medical fear and dental anxiety in adolescent girls was proved by Pearson's correlation coefficient (p < 0,01). In this study, CMFQ-M and CFSS-DS questionnaires were standardized in the Croatian adolescent population and proved reliable in the estimation of anxious behaviour with respect to specific medical and dental situations.
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Katsouda M, Provatenou E, Arapostathis K, Coolidge T, Kotsanos N. The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear. Int J Paediatr Dent 2017; 27:145-151. [PMID: 27192661 DOI: 10.1111/ipd.12236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND No studies assessing the association between gagging and dental fear are available in pediatric samples. AIM To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. DESIGN A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. RESULTS A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). CONCLUSIONS The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.
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Affiliation(s)
- Maria Katsouda
- Department of Paediatric Dentistry, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Konstantinos Arapostathis
- Department of Paediatric Dentistry, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Trilby Coolidge
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Nikolaos Kotsanos
- Department of Paediatric Dentistry, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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