Development of the first Arabic cognitive dental anxiety scale for children and young adults

AIM: To validate the Arabic version of abeer children dental anxiety scale. METHODS: Two ethical approvals for this study were obtained from United Arab Emirates, Ministry of Health and Dubai Health Authority; reference number: 2011/57. The Abeer children dental anxiety scale (ACDAS) was translated from English to Arabic by the native speaker chief investigator, and then back translated by another native speaker in Dubai (AS) to ensure comparability with the original one. Part C of ACDAS was excluded for the schoolchildren because those questions were only applicable for children at the dentist with their parents or legal guardian. A total of 355 children (6 years and over) were involved in this study; 184 in Dubai, 96 from the Religious International Institute for boys and 88 from Al Khansaa Middle School for girls. A sample of 171 children was assessed for external validity (generalizability) from two schools in different areas of London in the United Kingdom. RESULTS: Receiver operating characteristic curve showed that the cut-off >= 26 for ACDAS gave the optimal results for sensitivity = 90% (95% CI: 81.2%-95.6%), and specificity = 86.6% (95% CI: 78.2%-92.7%), with AUROC = 0.93 (95% CI: 0.90-0.97). Cronbach's Alpha (alpha) was 0.90 which indicated good internal consistency. Results of the external validity assessing the agreement between ACDAS and dental subscale of the children's fear survey schedule was substantial for the East London school (kappa = 0.68, 95% CI: 0.53-0.843); sensitivity = 92.9% (95% CI: 82.7%-98.0%); specificity = 73.5% ( 95% CI: 55.6%-87.1%) and almost perfect for the Central London school (kappa = 0.79; 95% CI: 0.70-0.88); sensitivity = 96.4% (95% CI: 81.7%-99.9%); specificity = 65.9%, (95% CI: 57.4%-73.8%). CONCLUSION: The Arabic ACDAS is a valid cognitive scale to measure dental anxiety for children age 6 years or over. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.