Assessing Dental Anxiety in Naïve Patients: Development and Validation of the Naïve Dental Anxiety Scale (NDAS)

Background The existing Modified Dental Anxiety Scale (MDAS) is widely used to assess dental anxiety; however, it includes experience-based terminology that may not be appropriate for naïve (first-time) dental patients. This study aimed to validate a Naïve Dental Anxiety Scale (NDAS), adapted from the MDAS, and establish its comprehensive rationality. Methods A cross-sectional study was conducted among 200 dental patients visiting the outpatient department of a tertiary care hospital for the first time (termed naïve patients). The NDAS was developed as a five-item questionnaire based on anticipatory dental anxiety constructs. Content validity was assessed using an expert panel, followed by face validation and pilot testing for clarity and comprehensibility. Participants completed both the NDAS and the Modified Dental Anxiety Scale (MDAS), along with demographic details. Psychometric evaluation included internal consistency using Cronbach's alpha, corrected item-total correlations, and criterion validity assessed through Spearman's correlation with MDAS. A two-tailed p-value <0.05 was considered statistically significant. Results The NDAS demonstrated acceptable content validity (item-level CVI (I-CVI) ≥0.78 and scale-level CVI (S-CVI) ≥0.80). Internal consistency was good (Cronbach's α=0.82), with corrected item-total correlations ranging from 0.49 to 0.70, indicating meaningful contributions of all items. A statistically significant moderate positive correlation was observed between NDAS and MDAS scores (Spearman's ρ=0.49, p<0.001), supporting criterion validity. Conclusion The NDAS demonstrates good internal consistency and acceptable validity for assessing dental anxiety at the group level in naïve patients.