This page lists commonly used research tools for measuring dental anxiety in adults. At the bottom of this page, you can also find a questionnaire for use in dental practices.
Before selecting a tool, the following summary of available dental anxiety scales gives an overview of their strengths and weaknesses:
Dental Anxiety Scales for Adults
Corah’s Dental Anxiety Scale, Revised (DAS-R)
Corah’s Dental Anxiety Scale (CDAS) consists of four questions about different dental situations. Each question is scored from 1 (not anxious) to 5 (extremely anxious) so the score range is 4 to 20. A score of 15 or more indicates profound anxiety.
Corah’s Dental Anxiety Scale (DAS-R) – PDF. The PDF file also includes a useful dental concerns assessment.
Modified Dental Anxiety Scale (MDAS)
The Modified Dental Anxiety Scale (MDAS) is similar to the DAS-R, but has an extra item about the respondent’s anxiety regarding a local anaesthetic injection, and the wording is slightly less scary than for the original Dental Anxiety Scale. It consists of 5 questions each with a 5 category rating scale, ranging from ‘not anxious’ to ‘extremely anxious’. The score can range from 5 to 25. The higher the score, the higher the level of fear. A score of 19 is the suggested cutoff point for high dental fear.
Kleinknecht Dental Fear Survey (DFS)
The Dental Fear Survey (DFS) was originally developed as a 27-item scale (Kleinknecht et al, 1973), and later reduced to 20 items (Kleinknecht et al, 1984). The score can range from 20 to 100. A cutoff point for high dental fear has been suggested at a score higher than 60. The scale has 3 dimensions: avoidance of dental treatment, physiological fear reaction, and anxiety caused by different dental stimuli.
Index of Dental Anxiety and Fear (IDAF-4C+)
The Index of Dental Anxiety and Fear (IDAF-4C+) was developed by Jason Armfield in 2010 to address some of the shortcomings of earlier instruments. It consists of three modules, which measure
- 4 components of dental fear (emotional, behavioural, physiological, cognitive)
- dental phobia, using DSM-IV based diagnostic criteria including the differential diagnosis of other conditions, and
- potential anxiety-inducing stimuli (IDAF-S).
The IDAF-S module is particularly useful in that it can provide valuable information for the dental practitioner regarding the person’s specific fears.
Other scales for adults include:
- Stouthard’s Dental Anxiety Inventory (DAI) – 36 items
- Stouthard’s Dental Anxiety Inventory short-form (DAI-S) – 9 items
- Gatchel’s 10-Point Fear Scale (FS) – 1 item
- How Do We Measure Dental Fear and What Are We Measuring Anyway? – Jason Armfield, 2010
For Dental Practices
Are you looking for a questionnaire for use in your dental practice? Our free dental fears questionnaire is available here:
You may also like:
- Dental Anxiety Management – information, videos, and advice around the management of nervous and phobic patients
Sources of Information
- Chi SI. What is the gold standard of the dental anxiety scale?. J Dent Anesth Pain Med. 2023 Aug;23(4):193-212.