dental anxiety questionnaire

Corah’s Dental Anxiety Scale, Revised (DAS-R)
Name ______________________________________________________ Date _____________
Norman Corah's Dental Questionnaire
1. If you had to go to the dentist tomorrow for a check-up, how would you feel about it?
a. I would look forward to it as a reasonably enjoyable experience.
b. I wouldn't care one way or the other.
c. I would be a little uneasy about it.
d. I would be afraid that it would be unpleasant and painful.
e. I would be very frightened of what the dentist would do.
2. When you are waiting in the dentist's office for your turn in the chair, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
3. When you are in the dentist's chair waiting while the dentist gets the drill ready to begin
working on your teeth, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
4. Imagine you are in the dentist's chair to have your teeth cleaned. While you are waiting
and the dentist or hygienist is getting out the instruments which will be used to scrape
your teeth around the gums, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
Scoring the Dental Anxiety Scale, Revised (DAS-R)
(this information is not printed on the form that patients see)
a = 1, b = 2, c = 3, d = 4, e = 5 Total possible = 20
Anxiety rating:
• 9 - 12 = moderate anxiety but have specific stressors that should be discussed and
managed
• 13 - 14 = high anxiety
• 15 - 20 = severe anxiety (or phobia). May be manageable with the Dental
Concerns Assessment but might require the help of a mental health therapist.
DENTAL CONCERNS ASSESSMENT*
Please rank your concerns or anxiety over the dental procedures listed below by ranking them
on the accompanying scale. Please fill in any additional concerns.
Level of Concern or Anxiety
Low Moderate High Don’t know
1. Sound or vibration of the drill 1 2 3 4
2. Not being numb enough 1 2 3 4
3. Dislike the numb feeling 1 2 3 4
4. Injection ("novocaine") 1 2 3 4
5. Probing to assess gum disease 1 2 3 4
6. The sound or feel of scraping during teeth cleaning 1 2 3 4
7. Gagging, for example during impressions of the
mouth 1 2 3 4
8. X-rays 1 2 3 4
9. Rubber dam 1 2 3 4
10. Jaw gets tired 1 2 3 4
11. Cold air hurts teeth 1 2 3 4
12. Not enough information about procedures 1 2 3 4
13. Root canal treatment 1 2 3 4
14. Extraction 1 2 3 4
15. Fear of being injured 1 2 3 4
16. Panic attacks 1 2 3 4
17. Not being able to stop the dentist 1 2 3 4
18. Not feeling free to ask questions 1 2 3 4
19. Not being listened to or taken seriously 1 2 3 4
20. Being criticized, put down, or lectured to 1 2 3 4
21. Smells in the dental office 1 2 3 4
22. I am worried that I may need a lot of dental
treatment 1 2 3 4
23. I am worried about the cost of the dental treatment
I may need 1 2 3 4
24. I am worried about the number of appointments and
the time that will be required for necessary appointments
and treatment; time away from work, or the
need for childcare or transportation 1 2 3 4
25. I am embarrassed about the condition of my mouth 1 2 3 4
26. I don't like feeling confined or not in control 1 2 3 4

*Developed by J.H. Clarke and S. Rustvold, Oregon Health Sciences University School of Dentistry, 1993
[revised 1998]

Dental anxiety

     Dental anxiety are common problem for many dentist in the world. because it was one of the factor that make the barrier between dentist and patient. dental anxiety usually come from childhood trauma. there are a lot of thing that makes trauma. for instance in Indonesia usually parent using dentist as a threat for their kid, they will tell their kid to do something if they didn't do it or listen to them they will take them to dentist. so, a lot of children always think that dentist are scary thing. the other problem is the dentist. a lot of dentist didn't really care about dental anxiety so they just force the kids to get the treatment and it makes their dental anxiety getting worse.
     Dental anxiety (DA) is a multi-system response to a believed threat or danger. It is an individual, subjective experience which varies among people. DA is a widespread phenomenon which ranks fifth among the most commonly feared situations for individuals. It can have a serious impact on daily life and is a significant barrier to seeking and receiving dental care. It has been estimated that the anxious patient requires approximately 20% more chair time than the non-anxious patient,which has an impact on cost. DA is seen in both children and adults, with child anxiety often manifesting as inappropriate or disruptive behavior. Unfortunately, many general dental practitioners are not willing to provide care for preschool children who display disruptive behavior, especially when more than simple treatment is required.In addition, the use of dental anxiety measures (DAMs) by dentists is lower than it could be.
     In order to consider any pediatric dental anxiety measurement as a gold standard measure, the scale should cover the following criteria: all types of reliability and validity a relatively bias-free method independent of procedural bias or patient/investigator response biases a versatile method that is applicable for both clinical and non-clinical use, which is practical in a variety of different dental settings a method that should yield numbers on an identifiable number scale (nominal, ordinal, interval, or ratio) so that the appropriate statistical analyses can be conducted short in length to maximize response from the children and minimize time for administration include items which are most relevant to the child dental experience easily hold the attention of the child and be simple to score and interpret.
      For self reported measures, the scale must be: age-appropriate and cover the cognitive status of the child; demonstrate reliability in scoring and test-retest reliability; be valid with respect to correlating with other indices such as behavior during treatment, dentists’ ratings of cooperation and mothers’ expectations of behavior and be numerical in order to rank dental anxiety causing items objectively and reliably. Reliability is necessary but not sufficient for validity.
     DAMs for children of age ≥6 years old should also assess information related to underlying beliefs and anxiety, as negative thinking patterns play a crucial role in fear evocation that could make the person apprehensive and difficult to treat, and the degree of belief in negative cognition is associated with the severity of dental anxiety. This will help dentists to understand the specific fears of patients, which in turn might help the patients to control his/her anxiety. Most DAMs only provide an overall estimate of perceived discomfort without understanding the causes of this anxiety. Therefore the objective of this study was to review pediatric dental anxiety measures and assess the statistical
methods that are used for validation and their clinical implications.


courtesy: Evidence-based dentistry:
analysis of dental anxiety
scales for children
A. Al-Namankany,1 M. de Souza2 and P. Ashley3