Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 18;21(1):651.
doi: 10.1186/s12903-021-02015-y.

Psychometric evaluation of the Lebanese Arabic version of the Dental Fear Survey: a cross-sectional study

Affiliations

Psychometric evaluation of the Lebanese Arabic version of the Dental Fear Survey: a cross-sectional study

Hiba Kassem El Hajj et al. BMC Oral Health. .

Abstract

Background: Dental fear is a prevalent problem that can lead to poor dental health. The Kleinknecht's Dental Fear Survey (DFS) is one of the used scales to assess dental fear. The present study aims to evaluate the psychometric properties of the Lebanese Arabic version of the DFS (DFS-A) and to determine the optimal cut-off to identify dental fear as well as the correlates of dental fear in a group of Lebanese adults dental patients.

Methods: A cross-sectional study was conducted among a group of 442 dental patients (18-65 years) recruited at 29 dental clinics from March to June 2019. Patients completed a questionnaire including questions about demographic characteristics, previous bad dental experience, trauma's experience period, the sensation of nausea during dental treatment, the DFS-A scale, the Lebanese Arabic version of the Modified Dental Anxiety Scale (MDAS-A), and a general question about dental fear.

Results: DFS-A revealed evidence of adequate psychometric properties. DFS-A scale demonstrated high internal consistency (cronbach's alpha = 0.93). Test-retest reliability assessment demonstrated strong reproducibility of the DFS-A scale score (ICC = 0.92 with 95% CI (0.83-0.96), p value < 0.0001 (N = 30). Confirmatory factor analysis revealed a three-factor structure of the DFS-A reflecting fear associated with specific dental stimuli and procedures, patterns of dental avoidance and anticipatory anxiety, and physiologic arousal during dental treatment. A significant correlation was found between DFS-A and the MDAS-A indicating a good convergent validity. The optimal cut-off point to identify patients with and without dental fear is 41. Considering this cut-off score, the prevalence of dental fear in our sample was reported at 33.8%. Multivariable analysis showed that having previous scary and painful dental experiences, a sensation of nausea during treatment, and having dental anxiety were identified as predictors of dental fear.

Conclusion: The adapted Arabic version of the DFS (DFS-A) is a valid tool to evaluate dental fear among Lebanese adult patients.

Keywords: Arabic version; DFS; Dental Fear Survey; Lebanese; Psychometric properties.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Three-factor model of the Arabic version of the Dental Fear Survey (DFS-A)
Fig. 2
Fig. 2
Receiver operating curve (ROC) curve showing sensitivity as a function of 1-Specificity of the Dental Fear Survey (DFS-A)h

Similar articles

Cited by

References

    1. Corah NL. Development of a dental anxiety scale. J Dent Res. 1969;48(4):596. doi: 10.1177/00220345690480041801. - DOI - PubMed
    1. Pohjola V, Lahti S, Tolvanen M, Hausen H. Dental fear and oral health habits among adults in Finland. Acta Odontol Scand. 2008;66(3):148–153. doi: 10.1080/00016350802089459. - DOI - PubMed
    1. Tolvanen M, Puijola K, Armfield JM, Lahti S. Translation and validation of the Finnish version of index of dental anxiety and fear (IDAF-4C(+)) among dental students. BMC Oral Health. 2017;17(1):85. doi: 10.1186/s12903-017-0375-4. - DOI - PMC - PubMed
    1. Kleinknecht RA, Klepac RK, Alexander LD. Origins and characteristics of fear of dentistry. J Am Dent Assoc (1939) 1973;86(4):842–848. doi: 10.14219/jada.archive.1973.0165. - DOI - PubMed
    1. Kleinknecht RA, Thorndike RM, McGlynn FD, Harkavy J. Factor analysis of the dental fear survey with cross-validation. J Am Dent Assoc (1939). 1984;108(1):59–61. doi: 10.14219/jada.archive.1984.0193. - DOI - PubMed