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      UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results


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          A recent UK population survey of oral health included questions to assess dental anxiety to provide mean and prevalence estimates of this important psychological construct.


          A two-stage cluster sample was used for the survey across England, Wales, and Northern Ireland. The survey took place between October-December 2009, and January-April 2010. All interviewers were trained on survey procedures. Within the 7,233 households sampled there were 13,509 adults who were asked to participate in the survey and 11,382 participated (84%).


          The scale was reliable and showed some evidence of unidimensionality. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Percentiles and confidence intervals were presented and can be estimated for individual patients across various age ranges and gender using an on-line tool.


          The largest reported data set on the MDAS from a representative UK sample was presented. The scale’s psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Practitioners within the UK have a resource to estimate the rarity of a particular patient’s level of dental anxiety, with confidence intervals, when using the on-line percentile calculator.

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          Most cited references28

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          Investigation of the single case in neuropsychology: confidence limits on the abnormality of test scores and test score differences.

          Neuropsychologists often need to estimate the abnormality of an individual patient's test score, or test score discrepancies, when the normative or control sample against which the patient is compared is modest in size. Crawford and Howell [The Clinical Neuropsychologist 12 (1998) 482] and Crawford et al. [Journal of Clinical and Experimental Neuropsychology 20 (1998) 898] presented methods for obtaining point estimates of the abnormality of test scores and test score discrepancies in this situation. In the present study, we extend this work by developing methods of setting confidence limits on the estimates of abnormality. Although these limits can be used with data from normative or control samples of any size, they will be most useful when the sample sizes are modest. We also develop a method for obtaining point estimates and confidence limits on the abnormality of a discrepancy between a patient's mean score on k-tests and a test entering into that mean. Computer programs that implement the formulae for the confidence limits (and point estimates) are described and made available.
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            The Modified Dental Anxiety Scale: validation and United Kingdom norms.

            The Corah Dental Anxiety Scale (CDAS) has been used extensively in epidemiology and clinical research. It is brief and is claimed to have good psychometric properties. However, it does not include any reference to local anaesthetic injections, a major focus of anxiety for many. Also, the multiple choice answers for three of the four questions are not clearly in order of severity of anxiety as the CDAS intends. The answers differ among the questions thus making them difficult to compare. They include descriptions of physiological reactions and anxiety, confusing two loosely related components of the experience. The Modified Dental Anxiety Scale (MDAS) described, added a question on anxiety about oral injections. New multiple choice answers, in clear order of anxiety and the same for each question, were provided. Twenty five dental personnel all confirmed independently the order of the multiple choice answers for the MDAS. They disagreed among themselves however, about the appropriate sequence for the answers denoting intermediate anxiety in the CDAS. Therefore the CDAS, unlike the MDAS, can provide meaningful measures only of extremely high or extremely low dental anxiety. Of 1392 subjects tested, 13 per cent expressed extreme anxiety about injections on the MDAS but were only 'fairly' or less anxious about drilling. Thus, the CDAS, unlike the MDAS, must overlook subjects very afraid of injections only. Data confirm the high reliability and validity of the MDAS and provide norms for phobic and nonphobic subjects.
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              Development of a dental anxiety scale.

              N Corah (2015)

                Author and article information

                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central
                24 June 2013
                : 13
                : 29
                [1 ]Health Psychology, University of St Andrews, Scotland, UK
                [2 ]School of Psychology, University of Aberdeen, Scotland, UK
                [3 ]Dental Public Health, University of Birmingham, England, UK
                [4 ]Dundee Dental School, University of Dundee, Scotland, UK
                [5 ]DHSRU, University of Dundee, Scotland, UK
                [6 ]Dental Public Health, NHS Tayside, Scotland, UK
                Copyright ©2013 Humphris et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 6 February 2013
                : 11 June 2013
                Research Article

                dental anxiety,representative survey,psychometrics,percentiles,on-line calculator
                dental anxiety, representative survey, psychometrics, percentiles, on-line calculator


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