Dental and Medical Problems
2017, vol. 54, nr 4, October-December, p. 389–395
Publication type: original article
Utility of the visual analog scale for the assessment of dental anxiety
Przydatność skali wzrokowo-analogowej do oceny poziomu lęku stomatologicznego
1 Department of Dental Prosthetics, Wroclaw Medical University, Wroclaw, Poland
2 Department of Toxicology and Health Protection, Medical University of Silesia, Katowice, Poland
Background. Psychometric scales can be used to assess the level of dental anxiety, but for practical reasons these are not routinely used in practice. This provides the opportunity to look for a simpler method that can be applied in the everyday work of a dentist.
Objectives. The study was designed to determine the utility of the visual analog scale (VAS) for dental anxiety assessment.
Material and Methods. The study involved 315 patients who were awaiting their appointments; they were asked to complete a survey consisting of a scale and questionnaires: Modified Dental Rating Scale (MDAS), Kleinknecht’s Dental Fear Survey (DFS), Dental Beliefs Survey (DBS), and Visual Analog Scale (VAS) of anxiety.
Results. An assessment of anxiety level measured by the MDAS scale showed that the majority of patients in the study group were patients with an average level of anxiety (68%), 25% with low and 7% with high levels of anxiety (phobia). The DFS found that 45% were patients with low anxiety levels, 48% with an average level, and 7% with phobias. By using the DBS scale, it was observed that the vast majority of respondents showed average confidence (70%), 26% high trust and only 4% did not trust the dentist. There is a high correlation between VAS scores and MDAS and DFS scales.
Conclusion. The VAS scale can be a simple and reliable tool for assessing anxiety in patients before dental surgery.
dental anxiety, dental treatment, visual analog scale
lęk dentystyczny, leczenie stomatologiczne, skala wzrokowo-analogowa
- Kisely S. No mental health without oral health. Can J Psych. 2016;61:277–282.
- Boman UW, Wennström A, Stenman U, Hakeberg M. Oral health-related quality of life, sense of coherence and dental anxiety: An epidemiological cross-sectional study of middle-aged women. BMC Oral Health. 2012;12:14.
- Corah N.L. Development of a dental anxiety scale. J Dent Res. 1969;48:596.
- Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc. 1973;86:842–848.
- Kleinknecht RA, Thorndike RM, McGlynn FD, Harkavy J. Factor analysis of the dental fear survey with cross-validation. J Am Dent Assoc. 1984;108:59–61.
- Humphris GM, Morrison T, Lindsay SJ. The modified dental anxiety scale: Validation and United Kingdom norms. Commun Dent Health. 1995;12:143–150.
- Walawender I, Roczniak W, Nowak D, et al. Applicability of the numeric scale for anxiety evaluation in patients undergoing dental treatment. Dent Med Prob. 2015;52:205–214.
- Hjermstad MJ, Fayers PM, Haugen DF, et al. Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: A systematic literature review. J Pain Symptom Manage. 2011;41:1073–1093.
- Kaczmarek U, Mysiak-Dębska M, Dębska K, Grzebieluch W. Dental anxiety in students of the first years of the study of dentistry and medicine faculties. Dent Med Probl. 2010;47:343–349 [in Polish].
- Hierons RJ, Dorman ML, Wilson K, Averley P, Girdler N. Investigation of inhalational conscious sedation as a tool for reducing anxiety in adults undergoing exodontia. Br Dent J. 2012;213:15–19.
- Saatchi M, Abtahi M, Mohammadi G, Mirdamadi M, Binandeh ES. The prevalence of dental anxiety and fear in patients referred to Isfahan Dental School, Iran. Dent Res J (Isfahan). 2015:12:248–253.
- Dubielecka M, Rusyan E, Panczyk M, Mielczarek A. A preliminary assessment of the usefulness of the Polish language version of MDAS scale for the estimation of dental treatment anxiety levels among adults in Warsaw. Nowa Stomatol. 2016;21:4,203–207 [in Polish].
- Borowy M, Kowalewska K, Mazur A. Assessment of the level of anxiety and attitude toward to the dentist among the students of Cracow universities. Poradnik Stomatol. 2011;11:230–234 [in Polish].
- Merks K, Jaworska-Zaremba M. Fábián TK, Mierzwińska-Nastalska E. The analysis of dental fear scores in the Polish minority living in Hungary. Prot Stomatol. 2010;57:102–111 [in Polish].
- Wilk-Sieczak B, Gmyrek-Marciniak A. Children’s behaviour during their dental adaptation visits and their families’ attitudes towards dental treatment. Dent Med Probl. 2005;42:573–580 [in Polish].
- Wilk-Sieczak B, Zakrzewski M, Chmielewska-Łuczak D. Mothers fear of dental treatment and the cause of the first visits of the child, and factors predicting negative preschool child’s attitudes during dental treatment. Dent Med Probl. 2005;42:77–82 [in Polish].
- Olszewska I. Anxiety and belief in dentist-patient relations. Magazyn Stomatol. 2001;11:1,54–59 [in Polish].
- Kowalińska-Kania M, Nowak D, et al. Numerical scale for anxiety assessment in 10–15 years children undergoing dental treatment. Dent Med Probl. 2015;52:309–315.
- Recine R. Prevalence of dental fear among Vilnus pupils aged 12 to 15 years. Stomatolog Baltic Dent Maxillofac. 2003;5:52–56.
- Armfield JM, Spencer AJ, Stewart JF. Dental fear in Australia: Who’s afraid of the dentist? Aust Dent J. 2006;51:78–85.
- Olszewska I, Żarow M, Gofroń B, Paczyńska P. Anxiety level analysis before dental treatment. Magazyn Stomatol. 2000;10:7–8,58–62 [in Polish].
- Firat D, Tunc EP, Sar V. Dental anxiety among adults in Turkey. J Contemp Dent Pract. 2006;7:75–82.
- Appukuttan DP, Tadepalli A, Cholan PK, Subramanian S, Vinayagavel M. Prevalence of dental anxiety among patients attending a dental educational institution in Chennai, India questionnaire based study. Oral Health Dent Manag. 2013;12:289–294.
- Nicolas E, Collado V, Faulks D, Bullier B, Hennequin MA. National cross-sectional survey of dental anxiety in the French adult population. BMC Oral Health, 2007;7:12.
- Moore R, Birn H, Kirkegaard E, Brødsgaard I, Scheutz F. Prevalence and characteristics of dental anxiety in Danish adults. Community Dent Oral Epidemiol. 1993;21:292–296.
- Tunc EP, Firat D, Onur OD, Sar V. Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population. Community Dent Oral Epidemiol. 2005;33:357–362.
- Millar K, Jelicic M, Bonke B, Asbury AJ. Assessment of preoperative anxiety: Comparison of measures in patients awaiting surgery for breast cancer. Br J Anaesth. 1995;74:180–183.
- Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns. Anesth Analg. 2000;90:706–712.
- Romanik W, Kański A, Soluch P, Szymańska O. Questionnaires and declarative level of anxiety of patients before surgery. Anest Int Ter. 2009;2:94–99 [in Polish].
- Bahammam MA, Hassan MH. Validity and reliability of an Arabic version of the modified dental anxiety scale in Saudi adults. Saudi Med J. 2014;35:1384–1389.
- Meisel-Denes J, Pregiel B, Sulka A. Use of the nitric oxide for dental treatment. TPS, 2014;6:95–100 [in Polish].