The development of a dental anxiety scale with a cognitive component for children and adolescents.

To validate a dental anxiety scale with a cognitive component for use in children and adolescents.A total of 439 children (≥ 6 years old) were evaluated. For each child, 2 operators each assessed using the Abeer Children Dental Anxiety Scale (ACDAS) at visit-1, and the chief investigator also assessed using the Child Fear Survey Schedule-Dental Subscale (CFSS-DS) at visit-1 and using the ACDAS 2 weeks later. A sample of 274 children was assessed for external validity.A receiver operating characteristic curve showed that the cutoff 26 gave the optimal results for sensitivity (96%, 95% confidence interval [CI]=81.7~99.9) and specificity (66%, 95% CI=57.4~73.8), with an area under the curve of 0.80 (95% CI=0.73~0.87). ACDAS had substantial to almost perfect intra- and inter examiner reliability along with good concurrent validity (r=0.77) and discriminative validity (r=0.79). For convergent validity, ACDAS had a significant relationship between the Dental Anxiety (DA) scores and cognitive status P<.001. Cronbach's alpha (α) was 0.90, which indicated good internal consistency. The external validity results indicated that the scale was generalizable.The Abeer Children Dental Anxiety Scale is a valid cognitive scale to measure dental anxiety, and it encompasses the required criteria to be regarded as the gold standard among dental anxiety scales.