Trilby Coolidge

Reliability and validity of the Greek version of the Children's Fear Survey Schedule–Dental Subscale

BACKGROUND The Childrens Fear Survey Schedule-Dental Subscale (CFSS-DS) is a commonly used questionnaire which measures childrens dental fear. OBJECTIVE The aim of this study was to gather data to evaluate the psychometric properties of a Greek version of the CFSS-DS. METHODS A sample of 260 children aged 4-12 completed the Greek version of the CFSS-DS while in the waiting room of a paediatric dentist. The dentist, who was unaware of the childrens scores, rated the childrens behaviour during the dental appointment using the Frankl scale. Children who returned for a second dental appointment during the study period completed the CFSS-DS a second time. RESULTS The mean CFSS-DS score was 24.80 (standard deviation = 9.17). Age and gender were not related to mean scores. Invasiveness of dental treatment was not related to mean scores. Children who were most uncooperative/fearful on the Frankl had the highest mean scores (Kruskal-Wallis chi2 = 9.48; d.f. = 2; P = 0.009). The internal consistency (Cronbachs alpha) was 0.85, and the test-retest reliability (intraclass correlation) was 0.74. CONCLUSIONS The Greek version of the CFSS-DS appears to be reliable and valid. Further samples should include school samples, to include children who may not go to the dentist.

Additional psychometric data for the Spanish Modified Dental Anxiety Scale, and psychometric data for a Spanish version of the Revised Dental Beliefs Survey.

BackgroundHispanics comprise the largest ethnic minority group in the United States. Previous work with the Spanish Modified Dental Anxiety Scale (MDAS) yielded good validity, but lower test-retest reliability. We report the performance of the Spanish MDAS in a new sample, as well as the performance of the Spanish Revised Dental Beliefs Survey (R-DBS).MethodsOne hundred sixty two Spanish-speaking adults attending Spanish-language church services or an Hispanic cultural festival completed questionnaires containing the Spanish MDAS, Spanish R-DBS, and dental attendance questions, and underwent a brief oral examination. Church attendees completed the questionnaire a second time, for test-retest purposes.ResultsThe Spanish MDAS and R-DBS were completed by 156 and 136 adults, respectively. The test-retest reliability of the Spanish MDAS was 0.83 (95% CI = 0.60-0.92). The internal reliability of the Spanish R-DBS was 0.96 (95% CI = 0.94-0.97), and the test-retest reliability was 0.86 (95% CI = 0.64-0.94). The two measures were significantly correlated (Spearmans rho = 0.38, p < 0.001). Participants who do not currently go to a dentist had significantly higher MDAS scores (t = 3.40, df = 106, p = 0.003) as well as significantly higher R-DBS scores (t = 2.21, df = 131, p = 0.029). Participants whose most recent dental visit was for pain or a problem, rather than for a check-up, scored significantly higher on both the MDAS (t = 3.00, df = 106, p = 0.003) and the R-DBS (t = 2.85, df = 92, p = 0.005). Those with high dental fear (MDAS score 19 or greater) were significantly more likely to have severe caries (Chi square = 6.644, df = 2, p = 0.036). Higher scores on the R-DBS were significantly related to having more missing teeth (Spearmans rho = 0.23, p = 0.009).ConclusionIn this sample, the test-retest reliability of the Spanish MDAS was higher. The significant relationships between dental attendance and questionnaire scores, as well as the difference in caries severity seen in those with high fear, add to the evidence of this scales construct validity in Hispanic samples. Our results also provide evidence for the internal and test-retest reliabilities, as well as the construct validity, of the Spanish R-DBS.

Psychometric properties of Spanish-language adult dental fear measures

BackgroundIt would be useful to have psychometrically-sound measures of dental fear for Hispanics, who comprise the largest ethnic minority in the United States. We report on the psychometric properties of Spanish-language versions of two common adult measures of dental fear (Modified Dental Anxiety Scale, MDAS; Dental Fear Survey, DFS), as well as a measure of fear of dental injections (Needle Survey, NS).MethodsSpanish versions of the measures were administered to 213 adults attending Hispanic cultural festivals, 31 students (who took the questionnaire twice, for test-retest reliability), and 100 patients at a dental clinic. We also administered the questionnaire to 136 English-speaking adults at the Hispanic festivals and 58 English-speaking students at the same college where we recruited the Spanish-speaking students, to compare the performance of the English and Spanish measures in the same populations.ResultsThe internal reliabilities of the Spanish MDAS ranged from 0.80 to 0.85. Values for the DFS ranged from 0.92 to 0.96, and values for the NS ranged from 0.92 to 0.94. The test-retest reliabilities (intra-class correlations) for the three measures were 0.69, 0.86, and 0.94 for the MDAS, DFS, and NS, respectively. The three measures showed moderate correlations with one another in all three samples, providing evidence for construct validity. Patients with higher scores on the measures were rated as being more anxious during dental procedures. Similar internal reliabilities and correlations were found in the English-version analyses. The test-retest values were also similar in the English students for the DFS and NS; however, the English test-retest value for the MDAS was better than that found in the Spanish students.ConclusionWe found evidence for the internal reliability, construct validity, and criterion validity for the Spanish versions of the three measures, and evidence for the test-retest reliability of the Spanish versions of the DFS and NS.

The Dental Neglect Scale in adolescents

BackgroundDental neglect has been found to be related to poor oral health, a tendency not to have had routine check-ups, and a longer period of time since the last dental appointment in samples of children and adults. The Dental Neglect Scale (DNS) has been found to be a valid measure of dental neglect in samples of children and adults, and may be valid for adolescents as well. We administered the DNS to a sample of adolescents and report on the relationships between the DNS and oral health status, whether or not the adolescent has been to the dentist recently for routine check-ups, and whether or not the adolescent currently goes to a dentist. We also report the internal and test-retest reliabilities of the DNS in this sample, as well as the results of an exploratory factor analysis.MethodsOne hundred seventeen adolescents from seven youth groups in the Seattle-Tacoma metropolitan area (Washington State, U.S.) completed the DNS and indicated whether they currently go to a dentist, while parents indicated whether the adolescent had a check-up in the previous three years. Adolescents also received a dental screening. Sixty six adolescents completed the questionnaire twice. T-tests were used to compare DNS scores of adolescents who have visible caries or not, adolescents who have had a check-up in the past three years or not, and adolescents who currently go to a dentist or not. Internal reliability was measured by Cronbachs alpha, and test-rest reliability was measured by intra-class correlation. Factor analysis (Varimax rotation) was used to examine the factor structure.ResultsIn each comparison, significantly higher DNS scores were observed in adolescents with visible caries, who have not had a check-up in the past three years, or who do not go to a dentist (all p values < 0.05). The test-retest reliability of the DNS was high (ICC = 0.81), and its internal reliability was acceptable (Cronbachs alpha = 0.60). Factor analysis yielded two factors, characterized by home care and visiting a dentist.ConclusionThe DNS appears to operate similarly in this sample of adolescents as it has in other samples of children and adults.

A form of 'parental presence/absence' (PPA) technique for the child patient with dental behaviour management problems.

AIM: This paper reports on the use of early introduction of a specific parental presence/absence (PPA) behavioural technique to manage the initially uncooperative child. METHODS: Using a prospective design, 440 healthy children aged 3 to 10 years visited a paediatric dental practice within 33 months. Children exhibiting initially Frankl ‘negative’ and ‘definitely negative’ behaviour were empathically offered parental presence only if they were cooperative. Otherwise, the parent stepped out until behaviour improvement. Statistics: t-tests and Chi-square tests were used to compare characteristics of initially cooperative and uncooperative children, as well as proportions of parents who were asked to leave the surgery. The technique’s success was assessed by a one sample binomial test. RESULTS: 75 of the children presented as Frankl either ‘negative’ (30) or ‘definitely negative’ (45) at theirfirst visit; 70 (93.3%, p< 0.001) responded to the PPA technique by displaying positive behaviour as their first visit progressed. 38 responded without the need to ask the parent to exit the practice room, while the other 32 responded only after their parent exited. 52 children had additional appointments, and 8 required an application of PPA at a second appointment; all children cooperated in all subsequent appointments. CONCLUSION: Early and empathic application of the PPA technique appears very successful in managing initially uncooperative child patients, suggesting that a randomised controlled trial of the technique is warranted

Recruiting rural dentally-avoidant adolescents into an intervention study.

AIM: To carry out a study designed to test an intervention to increase dental attendance in rural dentally-avoidant adolescents, to identify and recruit eligible adolescents. STUDY DESISN AND METHODS: This study used a cross-sectional design to identify eligible adolescents. A total of 2,762 adolescents (60% of the enrolled students) from junior high and senior high schools in a rural county in Washington State (USA) were given a dental examination with a light and mirror by calibrated dental examiners using WHO criteria. Parents of children with serious dental needs were urged to seek dental care for their adolescent children. They were offered the chance to enrol their child in a study comparing two programs designed to help the adolescent decide whether to seek out dental care. A second group of emancipated adolescents and young adults (aged < 26 years) receiving services at the local college and health department was also screened, and eligible individuals were also offered the chance to enrol. RESULTS AND STSTISTICS: Only 23 (6%) of 357 eligible junior and senior high school adolescents enrolled, compared with 24 (67%) of the 36 eligible emancipated adolescents and young adults. A second follow-up letter was sent to the 85 parents of un-enrolled adolescents with the most severe caries, offering direct assistance in obtaining dental care for their children; only 3 families responded. CONCLUSIONS: This study illustrates the difficulty in engaging adolescents in their oral health and utilization of oral health interventions. The results also suggest that slightly older rural individuals are more interested in and/or able to overcome barriers to seeking out dental care. Alternative strategies are suggested for recruiting avoidant adolescents.

Psychometric properties of the Greek version of the Toronto Composite Empathy Scale in Greek dental students

INTRODUCTION Empathy levels of health practitioners are related to patient satisfaction and treatment outcomes. The Toronto Composite Empathy Scale (TCES) was recently developed to assess cognitive and emotional empathy levels in both professional and personal spheres, and tested in an English-speaking sample of dental students. The aim of this study was to examine the psychometrics of the Greek version of the TCES. MATERIALS AND METHODS The TCES was translated into Greek and administered to all of the dental students at Aristotle University of Thessaloniki. A random subset of students completed the questionnaire twice for test-retest analysis. RESULTS Nearly all (96.5%) of the students completed the questionnaire. The internal consistencies of each of the four subscales were generally acceptable (Cronbachs alphas: 0.676-0.805), and the scale showed good discriminant and convergent validities (rs for discriminant validity: 0.217 and 0.103; rs for convergent validity: 0.595 and 0.700). Test-retest reliabilities ranged from 0.478 to 0.779. After eliminating items that fell on both cognitive and emotional factors, a rotated factor analysis indicated that the items loaded on two cognitive and three emotional factors. DISCUSSION Our results indicate that the Greek version of the TCES has good psychometric properties. The factor analysis indicates that the emotional and cognitive aspects of empathy are distinct, supporting the need to address both aspects in studies of empathy. CONCLUSIONS The Greek version of the TCES is a reliable and valid tool for the measurement of cognitive and emotional empathy, in both professional and personal life, in Greek dental students.

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear

BACKGROUND No studies assessing the association between gagging and dental fear are available in pediatric samples. AIM To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. DESIGN A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Childrens Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. RESULTS A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbachs alpha = 0.697). CONCLUSIONS The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

Predictors of Dental Patients' Satisfaction in a Greek Sample

Aims: To evaluate patien t factors, provider factors, and factors related to the patient - provider experience which may predict patient satisfaction with dental appointments. Study Design : A cross - sectional design was used. Place and Duration of Study: Data were gathered from denta l students and their patients at Aristotle University of Thessaloniki, Greece between October, 2010 and April, 2011. Methodology: Data from 157 dental students and 484 of their patients were included. Patients completed questionnaires including the Patient Communication Style Scale, the Patient Assessment Questionnaire, and the Dental Visit Satisfaction Scale, and items measuring the patient’s prior experience with his/her student dentist. Dental students completed questionnaires included the Toronto Compos ite Empathy Scale and the Attitudes Toward Patient Education Scale. Participants also provided demographic information, and the type of dental treatment received was recorded. Results: Patient satisfaction was associated with student communication skills ( P <.001) and dyadic congruence about patient participation in treatment - planning ( P <.001). Empathy was