Turkish version of the faces version of the Modified Child Dental Anxiety Scale (MCDASf): translation, reliability, and validity

White vs. colored coats: Which reduces dental anxiety better?

BACKGROUNDS

To evaluate the effect of colored vs. white coat wear on dental anxiety in children using psychometric, projective, and physiological methods.

METHODS

The participants were divided into two groups by the pediatric dentist based on the participants' coat color (white vs. colored), and procedures were performed during two separate appointments for both groups: dental examination (DE) and preventive dental treatments (PDT). The blood pressure, pulse rate, and saturation were recorded before and after each appointment. Anxiety was assessed using the Modified Child Dental Anxiety Scale Faces Version (MCDASf) before and after the appointments and the Child Drawing: Hospital (CD: H). Chi-Square, Mann-Whitney U test, Wilcoxon Signed-Rank test, and t-test were used for analysis. The statistical significance level was evaluated as P < 0.05.

RESULTS

Compared to the colored coat group, MCDASf values ​​recorded before both appointments were higher in the white coat group (P = 0.019; P = 0.034). Also, it was observed that the CD: H values of the colored coat group were significantly lower after PDT (P = 0.037). According to the coat groups, there was a significant difference between pulse rates measured before and after both appointments (P = 0.026; P = 0.017; P = 0.008; P = 0.004).

CONCLUSIONS

The clinician's coat color selection impacts children's dental anxiety. The findings suggest that colored coats are more effective than white coats in relieving dental anxiety.

Development of Cartoon-based Dental Anxiety Scale for Children: Validation and Reliability

Background

Dental fear and anxiety (DFA) is a common, deterring problem affecting children, which has a significant negative impact on children's oral health, leading to avoidance of dental care, poor dental hygiene, and an increased risk of dental caries and other oral health problems. The Oddbods DFA assessment is an innovative, child-friendly instrument that has been developed to assess DFA in children.

Aim

To evaluate the reliability and validity of the scale, and to examine the internal consistency, test-retest reliability, and criterion and construct validity of the scale.

Materials and methods

This study has assessed the reliability, criterion validity, and construct validity of the novel Oddbods anxiety assessment scale among 4-6-year-old children. Different samples were recruited to assess different criteria. A normative study was done to assess the distribution of age of the children according to anxiety levels. For assessing the test's retest reliability statistically, Statistical Package for the Social Sciences (SPSS) software version 23.0, Cronbach's α, interclass correlation coefficient, and t-test were used. For evaluating the criterion validity, the Spearman correlation coefficient was used. The Kaiser-Meyer-Olkin (KMO) test was used in an exploratory factor analysis to determine whether the sample size was sufficient for the factor analysis.

Results

The scale had a high positive correlation with the modified child dental anxiety scale (MCDAS), which is considered a gold standard, and a higher Cronbach's α value, which proved its internal consistency. It also showed a significant difference between anxious and nonanxious children, but there were no differences in the scores with respect to age.

Conclusion

The present scale proved to be a very effective tool for assessing DFA among young children.

Clinical significance

It is important to identify children at risk of dental anxiety. This scale helps to follow-up on children for their innate DFA, evaluate the efficacy of dental anxiety interventions, enhance communication, and improve access to dental care by encouraging children to seek dental care without fear or hesitation, promoting preventive care and better oral health outcomes.

How to cite this article

Fathima A, Ravikumar R, Chellappa LR. Development of Cartoon-based Dental Anxiety Scale for Children: Validation and Reliability. Int J Clin Pediatr Dent 2024;17(7):796-801.

Comparison of dexmedetomidine and a dexmedetomidine-esketamine combination for reducing dental anxiety in preschool children undergoing dental treatment under general anesthesia: A randomized controlled trial

BACKGROUND

Dental anxiety is a widespread complication occurring in pediatric patients during dental visits and may lead to undesirable complications. Esketamine may be effective in anxiety.

OBJECTIVE

The objective of this study was to investigate the effect of premedication with a dexmedetomidine-esketamine combination compared with dexmedetomidine alone on dental anxiety in preschool children undergoing dental treatment under general anesthesia.

METHODS

This is a prospective, double-blinded, randomized controlled trial. A total of 84 patients were scheduled for elective outpatient dental caries treatment under general anesthesia. Patients were randomly premedicated with intranasal dexmedetomidine (group D) or intranasal dexmedetomidine-esketamine (group DS). The primary outcome was the level of dental anxiety assessed by the Modified Child Dental Anxiety Scale (MCDAS) at 2 h after surgery. Secondary outcomes included level of dental anxiety at 1 day and 7 days after surgery, the incidence of dental anxiety at 2 h, 1 day, and 7 days after surgery, sedation onset time, overall success of sedation, acceptance of mask induction, postoperative pain intensity, incidence of emergence agitation in PACU, adverse reactions, HR, and SpO2 before premedication (baseline) and at 10, 20, and 30 min after the end of study drug delivery.

RESULTS

The dental anxiety in group DS was lower than that in group D at 2 h, 1 day, and 7 days postoperatively (P = 0.04, 0.004, and 0.006, respectively). The incidences of dental anxiety in group DS were lower than those in group D at 2 h (53 % vs 76 %, P = 0.03), 1 day (47 % vs 71 %, P = 0.04), and 7 days (44 % vs 71 %, P = 0.02) after surgery. Group DS had a higher success rate of sedation (P = 0.03) but showed a lower MAS score (P = 0.005) and smoother hemodynamics (P < 0.01) after drug administration than group D. Group DS showed a significantly lower incidence rate of emergence agitation (P = 0.03) and postoperative pain intensity (P = 0.006) than that in group D during the anesthesia recovery time. The occurrence of adverse reactions was similar in both groups (P > 0.05).

LIMITATIONS

We did not analyze and correct for the learning effect caused by repeated applications of the MCDAS and MCDAS scores on the 1 day after surgery were obtained by telephone follow-up.

CONCLUSIONS

Compared to premedication with dexmedetomidine alone, premedication with intranasal dexmedetomidine combined with esketamine could significantly improve dental anxiety in preschool children undergoing dental treatment under general anesthesia.

Interrater agreement between children's self-reported and their mothers' proxy-reported dental anxiety: a Chinese cross-sectional study

BACKGROUND

Children's dental anxiety is common in dental clinics. This study aimed to determine the interrater agreement between children's self-reported and their mothers' proxy-reported dental anxiety and its affecting factors.

METHODS

In this cross-sectional study performed in a dental clinic, primary school students and their mothers were assessed for enrollment eligibility. The Modified Dental Anxiety Scale plus Facial Image Scale (MDAS-FIS) was employed to test both the children's self-reported and their mothers' proxy-reported dental anxiety independently. The interrater agreement was analyzed using percentage agreement and the linear weighted kappa (k) coefficient. Factors affecting children's dental anxiety were analyzed using univariate and multivariate logistic regression models.

RESULTS

One hundred children and their mothers were enrolled. The median ages of the children and mothers were 8.5 and 40.0 years old, respectively, and 38.0% (38/100) of the children were female. The scores of children's self-reported dental anxiety were significantly higher than their mothers' proxy-reported dental anxiety (MDAS-Questions 1-5, all p < 0.05); moreover, there was no agreement between the two groups in terms of all anxiety hierarchies (kappa coefficient = 0.028, p = 0.593). In the univariate model, a total of seven factors (age, gender, maternal anxiety, number of dental visits, mother's presence or absence, oral health status, and having siblings or not) were involved for analysis, and age [every 1-year increase, odds ratio (OR) = 0.661, 95% confidence interval (CI) = 0.514-0.850, p = 0.001], several dental visits (every 1 visit increase, OR = 0.409, 95% CI = 0.190-0.880, p = 0.022), and mother presence (OR = 0.286, 95% CI = 0.114-0.714, p = 0.007) were affecting factors. In the multivariate model, only age (every 1 year increase) and maternal presence were associated with 0.697-fold (95% CI = 0.535-0.908, p = 0.007) and 0.362-fold (95% CI = 0.135-0.967, p = 0.043) decreases in the risk of children's dental anxiety during dental visits and treatment, respectively.

CONCLUSION

There was no significant agreement between elementary school students' self-reported dental anxiety and mothers' proxy ratings of children's dental anxiety, which suggests that self-reported dental anxiety by children should be encouraged and adopted, and the mother's presence during dental visits is strongly recommended.