Evaluating the validity of the Index of Dental Anxiety and Fear (IDAF-4C+) in adults with severe dental anxiety

Abstract

Dental anxiety is a common condition with severe consequences for oral health and health-related quality of life. The aim of this study was to evaluate the recently developed self-report scale Index of Dental Anxiety and Fear (IDAF-4C+) in adults with severe dental anxiety. A sample of 147 adults (age 20–71 yr) with severe dental anxiety completed a questionnaire including the IDAF-4C+ and three other dental anxiety scales. In a clinically assessed subgroup (n = 93), 95% had an International classification of diseases and related health problems 10th version (ICD-10) diagnosis of specific phobia for dentistry. Agreement between the scales was analysed using Spearman’s correlation, the Kappa measure of agreement and the intraclass correlation coefficient. The agreement of dental phobia according to the IDAF-4C+ phobia module and the ICD-10 was very low (ĸ = 0.02). The anxiety and fear module of the IDAF-4C+ showed acceptable agreement with the other scales (rs 0.69–0.75; ICC 0.90, 95% CI 0.87–0.93). We conclude that the IDAF-4C+ offers more information to clinicians and researchers than the older dental anxiety scales, but the phobia module needs further development.