Reliability and validity of the Turkish version of the abeer children dental anxiety scale (ACDAS)

Dental anxiety; this is a very common problem in dental patients and may cause problems for both the physician and the patient. Therefore, early detection of dental anxiety by dentists and identification of children that requiring special approaches increase the chance of success of dental treatment. The aim of this study is to evaluate the validity and reliability of the Turkish version of the Abeer Children Dental Anxiety Scale (ACDAS) which was developed for the measurement of dental anxiety in children. In this study, "Abeer Children Dental Anxiety Scale (ACDAS)" and "Children Fear Survey Schedule-Dental Subscale (CFSS-DS)" were administered to 122 patients between the ages of 7 and 12 by the chief investigator. At the same visit, 20 participants were re-administered ACDAS by another pediatric dentist. Two weeks later, ACDAS was re-administered to 122 participants by the chief investigator. Translation/re-translation method was used to test the language validity of the scale. Cohen's Kappa test was used to determine interobserver agreement for statistical analysis. In order to determine the validity of the scale Spearman correlation analysis and ROC (Reciever Operating Characteristic) analysis were used. For reliability analysis, Cronbach-Alfa (internal consistency) and Wilcoxon test were used in the whole test. In addition, McNemar and McNemar-Bowker tests were used for the questionnaire questions. The level of p <0.05 was considered significant in all analyses. According to the results; a high and statistically significant correlation was found in the Spearman correlation analysis between the ACDAS and CFSS-DS (r=0.760; p<0.001). As a result of the receiver operating characteristic curve analysis, ACDAS showed a good diagnostic performance (area under the curve=0.849). The reliability coefficient obtained from the internal consistency analysis revealed that the scale was a highly reliable scale (α=0.934). Cohen's Kappa test was used to determine the interobserver agreement between the two researchers and the results were found to be fully compatible with each other (κ =1, p<0.001). Results of Wilcoxon test showed that there was no statistically significant difference in the repetition of the answers given by the dentist in the evaluation of dental department, cognitive department and child, while there was a statistically significant difference in the part that the legal guardian answered in the evaluation of the child (p=0.004; p<0.01). In the Child Assessment section; in the analysis of the "Has your child had previous dental treatment?" (yes/no) question answered by legal guardian, found a statistically significant difference in the answers given (p<0.001). In the analysis of the "How do you expect your child's behaviour today?" (happy/ok/scared) question answered by legal guardian, not found a statistically significant difference in the answers given (p>0.05). As a result of the first administration of the Abeer Children Dental Anxiety Scale (ACDAS1) by the chief investigator, 78 (%63.9) patients were found carefree and 44 (%36.1) were anxious. Consequently, the Turkish version of ACDAS was found to be a valid and reliable tool for the assessment of dental fear in children aged 7-12 years.