Letter | Published:

Assessment of anxiety

BDJ volume 224, pages 843844 (08 June 2018) | Download Citation


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Sir, good measurement is the keystone to the scientific method. It is heartening to see therefore the paper by Shokouhi and Kerr in this Journal reviewing the Indicator of Sedation Need (IOSN).1 We note under the section of 'patient anxiety' that the Corah's dental anxiety scale (CDAS) might be considered as more accurate than the current measure: modified dental anxiety scale (MDAS). The basis of Shokouhi and Kerr's argument is a review of 15 dental anxiety measures by Newton and Buck published 18 years ago.2 We would caution substituting MDAS with CDAS based upon a review that is almost two decades old. The MDAS has now replaced the CDAS in study reports dated this century (88 vs 13 PubMed hits MDAS vs CDAS dental anxiety) and has extensive age/gender UK normative values.3 The recommendation should therefore hold to retain the MDAS as the recognised assessment of dental anxiety in the IOSN. We value the attention to the often neglected subject area of psychometrics in clinical assessment and decision making. It is hoped that this note will have made a useful addition to the continuing development of the IOSN.


  1. 1.

    , . A review of the indicator of sedation need (IOSN): what is it and how can it be improved? Br Dent J 2018; 224: 183–186.

  2. 2.

    , . Anxiety and pain measures in dentistry: a guide to their quality and application. J Am Dent Assoc 2000; 131: 1449–1457.

  3. 3.

    , , , , . UK population norms for the modified dental anxiety scale with percentile calculator: adult health survey 2009 results. BMC Oral Health 2013; 13: 29.

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    • R. Freeman
    •  & G. Humphris


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