Development of a Dental Anxiety Provoking Scale: A pilot study in Hong Kong

Background/purpose: Dental anxiety is closely related to one's past experience in dental clinics. However, little is known about what clinical, environmental, and psychological aspects provoke anxiety in dental patients. Extending on previous work in The Netherlands which explored anxiety provoking stimuli, the objective of the study was to develop a Dental Anxiety Provoking Scale (DAPS) that measures the degree to which anxiety was provoked by dental stimuli and to identify the underlying factor structure of the DAPS. Materials and methods: Four hundred and sixty study participants were recruited from two universities in Hong Kong. Each participant completed a self-administrated questionnaire that included a 73-item measure of dental anxiety provoking stimuli, and a four-item dental anxiety scale. Results: Results of exploratory and confirmatory factor analyses showed that the DAPS has seven factors, namely, dental check-up, injection, scale and drill, surgery, empathy, perceived lack of control, and clinic environment, and has 27 items. Results of structural equation modeling showed that three factors of the DAPS; dental check-up, surgery, and clinic environment, had a significant effect on dental anxiety score. The Cronbach α values ranged from 0.76 to 0.92 while the composite reliability values ranged from 0.78 to 0.93. The average variance extracted (AVE) values ranged from 0.55 to 0.81. The minimum AVE value was greater than the square of correlation value for each pair of factors. Conclusion: The study developed and validated the DAPS covering a wide range of dental anxiety provoking stimuli, findings were concise enough to be used in clinical based studies.