Updating a measure of dental anxiety: reliability, validity, and norms

The Corah Dental Anxiety Scale was introduced in 1969. Since then, changes in dental practice and language usage have dated the scale. The purposes of this study were to (1) slightly modify the scale, (2) assess its reliability and validity, and (3) develop norms for the revised version. The scale modifications recognized the roles of dental hygienists and female dentists in the dental office. Two variations of the first item also were constructed. One asked about going to the dentist "for a checkup¿; the other asked about going "because of a toothache."

The revised instrument was included in face-to-face interviews with 662 dentate adults living in the Detroit, Michigan, area. Reliability was estimated by Cronbach's alpha. Validity was examined by correlating the revised scale with another measure of dental anxiety and measures of conceptually related variables.

Cronbach's alpha coefficient was 0.82 for the checkup version of the scale, 0.79 for the toothache version, and 0.82 for a scale including both variations of the first item, indicating adequate reliability. Dental anxiety correlated positively with history of dental problems (r = .13, .09, and .10 for the checkup, toothache, and combined versions, respectively), negatively with frequency of preventive dental visits (r = -.28, -.22, and -.25), and positively with another measure of dental anxiety (r = .61, .59, and .62), supporting the validity of the scales.

The checkup version of the revised scale is recommended for future use. The Dental Anxiety Scale as modified continues to be a reliable and valid instrument 20 years after its introduction.