Cross-cultural adaptation and validation of the Swedish version of the Modified Dental Anxiety Scale

Introduction: The impact of dental anxiety is profound. At the same time, dental anxiety is sometimes difficult to detect. Therefore, a patient-reported outcome measure is needed. The Modified Dental Anxiety Scale (MDAS) is a short, internationally used self-assessment questionnaire for screening of dental anxiety. Aim: To cross-culturally adapt the original English MDAS to Swedish (MDAS-S), and to validate it in a Swedish setting. Materials and methods: The adaptation was conducted in accordance with recommended guidelines. Field testing was performed both among adults presenting for their regular dental check-ups and among adults diagnosed by a psychologist as dentally phobic. Results: The MDAS-S was formed during the adaptation procedure. Field testing included 246 adults presenting for their regular dental check-ups and 7 adults diagnosed with dental phobia. The MDAS-S score was significantly higher (p < 0.001) in the dentally phobic group than in the regular dental check-up group. Reliability was good with Cronbach’s Alpha values between 0.880 to 0.909. Test-retest of 37 individuals showed an excellent Intraclass Correlation Coefficient of 0.956. Confirmatory factor analysis (CFA) finds support for a two-factor model although with 78% shared variance between the factors. Conclusions: The MDAS-S demonstrates good reliability and appears valid as a screening tool for dental anxiety among Swedish adults.