The authors declare that they have no competing interests.
RE and ZYY were the principal investigators of the study. NAH and YA were involved in Study 1 and 2. RE and ZYY have revised the manuscript. All authors read and approved the final manuscript.
To evaluate the psychometric properties of the faces version of the Modified Child Dental Anxiety Scale (MCDASf) Malay version in 5–6 and 9–12 year-old children.
The MCDASf was cross culturally adapted from English into Malay. The Malay version was tested for reliability and validity in 3 studies. In the Study 1, to determine test-retest reliability of MCDASf scale, 166 preschool children aged 5–6 years were asked to rank orders five cartoons faces depicting emotions from ‘very happy’ to ‘very sad’ faces on two separate occasions 3 weeks apart. A total of 87 other 5–6 year-old children completed the Malay-MCDASf on two separate occasions 3 weeks apart to determine test-retest reliability for Study 2. In study 3, 239 schoolchildren aged 9–12 years completed the Malay-MCDASf and the Malay-Dental Subscale of the Children Fear Survey Schedule (CFSS-DS) at the same sitting to determine the criterion and construct validity.
In study 1, Kendall W test showed a high degree of concordance in ranking the cartoon faces picture cards on each of the 2 occasions (time 1, W = 0.955 and time 2, W = 0.954). The Malay-MCDASf demonstrated moderate test-retest reliability (Intraclass correlation coefficient = 0.63, p <0.001) and acceptable internal consistency for all the 6 items (Cronbach’s alpha = 0.77) and 8 items (Cronbach’s alpha = 0.73). The highest MCDASf scores were observed for the items ‘injection in the gum’ and ‘tooth taken out’ for both age groups. The MCDASf significantly correlated with the CFSS-DS (Pearson r = 0.67, p < 0.001).
These psychometric findings support for the inclusion of a cartoon faces rating scale to assess child dental anxiety and the Malay-MCDASf is a reliable and valid measure of dental anxiety in 5–12 year-old children.
Klingberg G, Berggren U, Noren JG. Dental fear in an urban Swedish child population: prevalence and concomitant factors. Community Dent Health. 1994;11(4):208–14. PubMed
Desiate A, Fanelli M, Milano V. “Odontogenic” anxiety. A study of a population of 1500 students from the public schools in the Bari area. Minerva Stomatol. 1997;46(4):165–73. PubMed
Shahardin RZR. Dental anxiety among 10–12 year-old schoolchildren in Malaysia. Kuala Lumpur, Malaysia: M Clint Dent Report, University of Malaya; 2003.
Christophorou S, Lee GTR, Humphris GM. The reliability and validity of the modified child dental anxiety scale: a study of Greek Cypriot school children. Eur J Paediatr Dent. 2000;1(2):75–81.
Hmud R, Walsh L. Dental anxiety: causes, complications and management approaches. J Minim Interv Dent. 2009;2(1):67–78.
Venham LL, Gaulin-Kremer E. A self-report measure of situational anxiety for young children. Pediatr Dent. 1979;1(2):91–6. PubMed
Cuthbert MI, Melamed BG. A screening device: children at risk for dental fears and management problems. ASDC J Dent Child. 1982;49(6):432–6. PubMed
Humphris GM, Milsom K, Tickle M, Holbrook H, Blinkhorn A. A new dental anxiety scale for 5-year-old children (DA5): description and concurrent validity. Health Educ J. 2002;61:5–19. CrossRef
Buchanan H, Niven N. Validation of a facial image scale to assess child dental anxiety. Int J Paediatr Dent. 2002;12(1):47–52. PubMed
Howard KE. Measuring and managing child dental anxiety. Phd thesis: Queen’s University Belfast; 2006.
Zhang HM, Xia B, Wang JH, Xie P, Huang Q, Ge LH. Chinese version of a face version of the modified child dental anxiety scale: transcultural adaptation and evaluation. Chinese J Stomatol. 2013;48(7):403–8.
Dayang Mariam AR, Ahmad A, Sujak SL, Noralaini I, Nooraini O, Fouziah G, et al. Refusal of dental treatment in the school dental service among primary schoolchildren. Int Dent J. 2001;51(5):360.
Siegel S, Castellan Jr NJ. Nonparametric Statistics for the Behavioural Sciences. Singapore: McGraw-Hill Book Co.; 1988.
Field A. Discovering Statistics Using SPSS. 2nd ed. London: Sage Publications Ltd.; 2005.
Acquadro C, Conway K, Giroudet C, Mear I. Linguistic validation manual for patient-reported outcomes (PRO) instruments. Lyon: Mapi Research Institute; 2004.
Oral Health Division Ministry of Health Malaysia. Oral Healthcare in Malaysia. Putrajaya: Oral Health Division Ministry of Health Malaysia; 2008.
Aartman IH, van Everdingen T, Hoogstraten J, Schuurs AH. Self-report measurements of dental anxiety and fear in children: a critical assessment. ASDC J Dent Child. 1998;65(4):252–8. 229–230. PubMed
Streiner DL, Norman GR. Health Measurement Scales. A Practical Guide to their Development and Use. 2nd ed. Oxford: Oxford Medical Publications; 1995.
- Psychometric properties of the faces version of the Malay-modified child dental anxiety scale
Noratikah Awang Hashim
Zamros Yuzadi Mohd Yusof
- BioMed Central
Neu im Fachgebiet Zahnmedizin
Mail Icon II