Development of the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+): Dental anxiety and concomitant factors in pediatric dental patients

Abstract

Objective: The aim of this study was to develop the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C(+)) and also to explore factors associated with dental anxiety in clinical pediatric dental patients (PDPs). Study Design: The study sample consisted of 421 PDPs aged 12-14, 104 of whom were selected for test-retest analysis. The psychometric evaluation included linguistic validity, exploratory factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intra-class correlation coefficient, ICC). Construct validity was tested by comparing a commonly used instrument, the Children's Fear Survey Schedule Dental Subscale (CFSS-DS). Associations between parental dental anxiety, frequency of dental visits, dental caries, dental visit behaviour and children's dental anxiety were also examined. Results: The Turkish version of the IDAF-4C demonstrated good internal consistency (Cronbach's alpha alpha=.96) and test-retest reliability (ICC=.87). Factor analysis showed a fit IDAF-4C model with a single factor, 8 items. Dental anxiety scores were significantly correlated with all measured variables (p<0.001). Girls showed significantly higher dental anxiety scores than boys (p<0.05). Conclusions: This study suggests that the Turkish version of the IDAF-4C(+) is a valid and reliable instrument for assessing dental anxiety and fear in Turkish children.