Psychometric properties of the faces version of the Malay-modified child dental anxiety scale

BACKGROUND: To evaluate the psychometric properties of the faces version of the Modified Child Dental Anxiety Scale (MCDAS(f)) Malay version in 5–6 and 9–12 year-old children. METHODS: The MCDAS(f) was cross culturally adapted from English into Malay. The Malay version was tested for reliability and validity in 3 studies. In the Study 1, to determine test-retest reliability of MCDAS(f) scale, 166 preschool children aged 5–6 years were asked to rank orders five cartoons faces depicting emotions from ‘very happy’ to ‘very sad’ faces on two separate occasions 3 weeks apart. A total of 87 other 5–6 year-old children completed the Malay-MCDAS(f) on two separate occasions 3 weeks apart to determine test-retest reliability for Study 2. In study 3, 239 schoolchildren aged 9–12 years completed the Malay-MCDAS(f) and the Malay-Dental Subscale of the Children Fear Survey Schedule (CFSS-DS) at the same sitting to determine the criterion and construct validity. RESULTS: In study 1, Kendall W test showed a high degree of concordance in ranking the cartoon faces picture cards on each of the 2 occasions (time 1, W = 0.955 and time 2, W = 0.954). The Malay-MCDAS(f) demonstrated moderate test-retest reliability (Intraclass correlation coefficient = 0.63, p <0.001) and acceptable internal consistency for all the 6 items (Cronbach’s alpha = 0.77) and 8 items (Cronbach’s alpha = 0.73). The highest MCDAS(f) scores were observed for the items ‘injection in the gum’ and ‘tooth taken out’ for both age groups. The MCDAS(f) significantly correlated with the CFSS-DS (Pearson r = 0.67, p < 0.001). CONCLUSIONS: These psychometric findings support for the inclusion of a cartoon faces rating scale to assess child dental anxiety and the Malay-MCDAS(f) is a reliable and valid measure of dental anxiety in 5–12 year-old children.