Inter-rater agreement between children's self-reported and parents' proxy-reported dental anxiety

Healthcare professionals often rely on parents to provide accurate dental anxiety assessment for their children. To date no studies have reported on inter-rater agreement between children's self-reported and their parents'/guardians' proxy-reported dental anxiety in the UK.

To assess the frequency of self-reported dental anxiety in 7-16-year-old children and the inter-rater agreement between children's self-reported and parent/guardian proxy-reported dental anxiety for their children.

Data were collected prospectively from 7-16-year-old children and their parents/guardians attending two community dental clinics in Fife, Scotland (July 2012-January 2013). Dental anxiety was assessed using faces version of Modified Child Dental Anxiety Scale. Questionnaires were separately and independently completed by children and their accompanying parent or guardian.

One hundred and thirty-two child-parent/guardian pairs participated in this study. Children's self-reported dental anxiety was 18% (n=24, 95% CI 12-25). Inter-rater agreement between children and their parent/guardian was poor for dental filling (linear weighted kappa coefficient 0.17) and tooth extraction (0.20), whereas other questions had fair inter-rater agreement (0.21-0.34). Parents' proxy-reported assessments significantly failed to recognise dental anxiety in 46% (n=11) dentally anxious children (p=0.0004).

Parent/guardian proxy-reported dental anxiety differs from children's self-reported dental anxiety suggesting children should be encouraged to self-report their dental anxiety.