Modified Child Dental Anxiety Scale-Faces (MCDASf): validity and reliability of the Brazilian version

Abstract

Specific measures for assessing dental anxiety and fear are crucial in pediatric dentistry for their management. This cross-sectional study aimed to test the validity and reliability of the Brazilian Portuguese version of the Modified Child Dental Anxiety Scale - Faces (MCDASf). A total of 189 children enrolled in public schools in Pelotas, Southern Brazil, and their parents were included. The children completed an interview that included the MCDASf, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Dental Anxiety Question (DAQ), and self-reported oral health-related outcomes. The parents provided sociodemographic data and information on dental visits and pain. Descriptive statistics, comparison and correlation tests, and psychometric analyses were conducted. The MCDASf scores were positively correlated with the CFSS-DS scores (rho = 0.60; p < 0.001). Children reporting dental anxiety (DAQ) had higher MCDASf scores. Exploratory factor analysis (EFA) was conducted on MCDASf items. The factor model was supported by Bartlett's test of sphericity (p < 0.001) and the Kaiser-Meyer-Olkin (KMO) measure (0.782). The loadings indicated that the two factors explained 18.9% and 13.9% of the variance. Factor 1 included items 1-3, 5, 7, and 8, whereas Factor 2 included items 4 and 6. The MCDASf showed satisfactory internal consistency: Cronbach's α = 0.73 and McDonald's ω = 0.82 for the total scale, with α and ω > 0.66 for both factors. Coefficients ≥ 0.70 are considered acceptable. This study provided psychometric evidence supporting the Brazilian MCDASf (B-MCDASf) as a reliable self-report tool for assessing dental anxiety in children in both clinical and research settings.