Do Maternal Beliefs, Knowledge and Practices for Own and Young Child Oral Care Reflect on Actual Child Oral Health?

AIM: The aim of the present study was to evaluate whether mother's oral health habits and knowledge for child oral care actually reflect on her young child's oral health and hence sought for direct evidence for this association. MATERIALS AND METHODS: One hundred mothers accompanied their children, aged 2-5 years to a University Pediatric Dentistry Clinic and completed a three-arm questionnaire. Child dental caries (decayed, missing, filled surfaces-dmfs) and gingival bleeding index (GBI) were recorded. Correlations were sought by the analysis of variance (ANOVA). RESULTS: A negative correlation was observed between maternal education and family income with child dmfs (p < 0.01). Additionally, other maternal factors such as age and correct knowledge of the appropriate age for a child's first dental visit, the initiation of toothbrushing, and fluoride exposure were positively associated with lower dmfs and GBI. Additionally, some maternal practices also contributed to these results. CONCLUSION: Maternal practices and knowledge are predictors of child oral health. CLINICAL SIGNIFICANCE: Mothers-to-be, especially those with low socioeconomic characteristics, should be involved in dental education and motivation interventions in order to practice proper oral hygiene for their children.

Intentional replantation and management of avulsion related ankylosis and external cervical resorption. A 10-year follow up case report.

Replantation is the treatment of choice for avulsed permanent teeth; ankylosis and cervical root resorption are among survival complications. A 9.5-year-old boy presented with an avulsed maxillary permanent central incisor with an open root apex following a school accident. The tooth was kept in milk, after a dry time of 15-20 min. Its replantation was performed 60 min after the accident. At 8 months, apexification with apical plug was attempted upon radiographic evidence of apical periodontitis. Ankylosis sound with infraocclusion and radiographic evidence of external cervical root resorption (ECR) were evident at 3 years and 3 months. At the patient's return one year later with esthetic concerns (2 mm infraocclusion) there was a 5 mm diameter ECR cavity. After intentional atraumatic extraction the resorptive cavity was debrided and restored with Biodentine; subsequently the tooth was reimplanted and splinted at an extruded position. At the 10-year follow up since the first avulsion the tooth remains esthetically pleasing, asymptomatic, non-ankylotic and functional. The present case supports intentional replantation as an option in managing infraoccluded teeth with advanced ECR.

Jet or conventional local anaesthesia? A randomized controlled split mouth study.

OBJECTIVES: To compare the efficacy, acceptance and preference of conventional infiltration technique with a needleless jet anaesthetic device (Comfort-In). MATERIALS AND METHODS: Non-fearful healthy adult volunteers, aged 19-40 years, were recruited in the Dental School of Aristotle University of Thessaloniki, Greece. Intact maxillary premolars were selected for local anaesthesia. Both techniques were applied sequentially with 35 min time gap on either buccal side on the same day by the same operator. The quadrant and the order of administration were randomly assigned using an online randomization generator. Immediately after administration, at 1, 3, 5, 10, 15, 20, 25 and 30 min, pulp vitality and soft tissue pain reaction tests were performed. Each participant was asked 6 questions in order to assess acceptance. At the end of the session, at 24 h and 7 days, all participants were asked to report any adverse events and their preference. RESULTS: In 63 volunteers who were successfully followed, 63 teeth received conventional local infiltration and 63 the Comfort-In. Both techniques presented with similar anaesthetic efficacy at 1, 3, 5, 10 and 15 min, whereas the conventional technique was more efficacious at 20 min (p < 0.005). Both presented similar acceptance apart from higher pain/discomfort during administration of Comfort-In (p = 0.002). Significantly higher preference was reported for the conventional technique immediately after the session, at 24 h and at 7 days (p < 0.0005); 19 (30.2%) reported the presence of ecchymosis or lacerations at the Comfort-In site as opposed to 5 (7.9%) with the conventional method (p < 0.0001). CONCLUSION: Both techniques showed similar effectiveness. Conventional infiltration was preferred to needleless anaesthesia by non-fearful adult volunteers and was associated with less adverse events. CLINICAL RELEVANCE: This study enhances the advantages of conventional local anaesthesia. TRIAL REGISTRATION: ISRCTN17400733.

Enamel opacities in all other than Molar Incisor Hypomineralisation index teeth of adolescents.

BACKGROUND: There are scarce data on the hypomineralisation of other permanent teeth (HOPT) than the index teeth of Molar Incisor Hypomineralisation (MIH). AIM: To report on the prevalence and surface pattern of HOPT and seek associations with MIH. DESIGN: Representative samples of urban Greek 14-year-olds were examined in classroom with a dental mirror. Their enamel defects were recorded using EAPD criteria for MIH. Descriptive statistics and correlation tests for HOPT vs previously reported MIH findings in the same samples were applied. RESULTS: HOPT prevalence in 1156 consented adolescents was 22.9%. 148 (16.2%) of 912 no-MIH children had HOPT; 117 (48.1%) of the 244 MIH children had HOPT too (OR 3.0, 95% CI 2.4-3.6). There were more HOPT teeth per child in the MIH vs no-MIH children (P < .001). HOPT tooth frequency was as follows: second molar 33.7%, canine 25.7%, first premolar 23.6%, and second premolar 17.0%. Enamel breakdown was seen in 5.3% HOPT children. Vestibular to intraoral surface defect ratio differed between jaws (maxilla 187/88, mandible 149/17, P < .05). CONCLUSIONS: Hypomineralisation defects in the MIH non-index teeth collectively had comparable prevalence and tooth surface patterns to MIH, but much lower severity. MIH was predictor for HOPT.

Prevalence of Dental Enamel Defects, Aphthous-Like Ulcers and Other Oral Manifestations in Celiac Children and Adolescents: A Comparative Study.

Objectives: Celiac disease (CD) is an autoimmune disease with typical, atypical and asymptomatic forms, in which many oral manifestations have been recognized. This study aims to evaluate the prevalence of oral manifestations as well as explore if oral examination could be used as a first diagnostic screening tool for atypical or asymptomatic forms. Study Design: 45 CD patients, between 2 and 18 years (mean age 10.3) and 45 healthy subjects, age and gender-matched, were examined for hard and soft tissue lesions such as dental enamel defects (DED), dental caries, aphthous-like ulcers (ALU), atrophic glossitis, geographic tongue, median rhomboid glossitis. Results: Statistically significant differences between the two groups were observed for the prevalence of DED (in 64,4% CD and 24,46% control patients, p=0.001), their location in the teeth (incisal: p=0.0001, middle: p=0.002, cervical: p=0.007), as well as for the prevalence of ALU (in 40% CD as opposed to 4,44% control patients, p=0.001). Conclusion: The presence of DED and ALU could be used as a sign of alert for possible atypical and asymptomatic forms of CD.

Gagging prevalence and its association with dental fear in 4-12-year-old children in a dental setting.

AIM: The aims were to determine the prevalence of gagging in children in the dental setting, detect any association between gagging and dental fear in that setting, and determine if the association varied by type of setting. DESIGN: A total of 734 children (4-12 years old), seeking dental care either at a University paediatric dental clinic (UC) or at a private paediatric practice (PP), filled out the Greek version of the Gagging Assessment Scale (GAS, subjective assessment) and the Greek version of the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS). The shorter form of the Gagging Problem Assessment-dentist part for children (GPA-de-c/SF, dentist's objective measurement) was used to assess their gag reflex. RESULTS: A total of 209 children (28.47%) gagged according to the GPA-de-c/SF. There was no significant difference in gagging between UC and PP children. Children rated as gaggers on the GPA-de-c/SF reported significantly higher GAS and CFSS-DS scores (U = 33 629.000; P < 0.001, U = 31 955.500, P < 0.001, respectively). Also, there was a significant association between GAS and CFSS-DS (rho = 0.307, P < 0.001). CONCLUSIONS: In the dental setting, there were significant relationships between dental fear, the dentist's objective measurement of gagging severity, and the child's subjective gagging assessment.

Periodontal Impact of Preformed Metal Crowns on Permanent Molars of Children and Adolescents: A Pilot Study.

PURPOSE: When treating an early permanent molar with coronal malformation in children, as in severe molar incisor hypomineralization (MIH) cases, preformed metal crowns (PMCs) are a successful mid- to long-term restorative option. The purpose of this study was to evaluate possible changes in periodontal tissues and subgingival microbiota after PMC placement by way of a split-mouth study. METHODS: Fourteen healthy patients with a mean age of 10.6 (±4.2) years old, attending a university dental clinic, had one MIH severely affected permanent first molar restored with a PMC (study side), while the contralateral relatively healthy tooth was the control. The Turesky plaque index, gingival index (GI), and pocket depth (PD) were assessed, and counts of periodontal pathogens were determined by checkerboard DNA-DNA hybridization at baseline and at the six-month recall. RESULTS: There were no defective PMCs at either examination time. GI and PD significantly increased statistically in the permanent molars under study from baseline to follow up, as did Porphyromonas gingivalis and Tannerella forsythia counts. CONCLUSION: The changes found in periodontal status and specific periodontal pathogens six months after preformed metal crown placement on permanent first molars warrant long-term follow-up to ascertain if these are reversible.

Performance of pit and fissure sealants according to tooth characteristics: A systematic review and meta-analysis.

OBJECTIVE: Aim of this systematic review was to assess the clinical performance of sealants on various teeth in an evidence-based manner. SOURCES: Five databases were searched from inception to February 2017. DATA: Randomized clinical studies on humans. METHODS: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, Paule-Mandel random-effects meta-analyses of Relative Risks (RRs) and their 95% confidence intervals (CIs) were calculated. RESULTS: A total of 16 randomized clinical trials with 2778 patients (male/female 49.1%/50.9%) and an average age of 8.4 years were included. No significant difference in either caries incidence of sealed teeth or sealant retention could be found according to (i) mouth side (right versus left), (ii) jaw (upper versus lower), (iii) and tooth type (1st permanent molar versus 2nd permanent molar/1st permanent molar versus 2nd deciduous molar/1st deciduous molar versus 2nd deciduous molar), based on evidence of very low to low quality. On the other side, compared to 1st permanent molars, sealed premolars were significantly less likely to develop caries (3 trials; RR=0.12; 95% CI=0.03 to 0.44; P=0.001) and less likely to experience loss of the sealant (5 trials; RR=0.33; 95% CI=0.20 to 0.54; P=0.001), both based on low to moderate quality evidence. CONCLUSIONS: The performance of pit and fissure sealants does not seem to be negatively affected by mouth side, jaw, and tooth type, apart from the exception of a favorable retention on premolars. CLINICAL SIGNIFICANCE: Based on existing evidence, pit and fissure sealants can be effectively applied on any deciduous or permanent posterior teeth without adverse effects on their clinical performance.

Dental arch spatial changes after premature loss of first primary molars: a systematic review of controlled studies.

Studies investigating dental arch spatial changes following first primary molar premature loss are controversial regarding clinical significance. The purpose of this review was to systematically investigate the relevant literature. Controlled studies investigating changes before and after premature loss of first primary molars were searched in various databases. Split-mouth design studies were considered eligible for inclusion. The risk of bias was judged according to ADA Clinical Practice Guidelines. Only two analyzable split-mouth studies on mandibular first primary molar loss were identified. Space loss in the extraction side was greater at 2, 4, 6 and 8-month follow-ups, reaching a -1.5 mm difference in the final examination (95% Confidence Interval: -2.080 to -0.925; p = 0.000; random effects model). Studies were judged to be at unclear risk of bias. The amount of space decrease after premature loss of first primary molars may have management implications under certain circumstances. Comprehensive assessment of the various characteristics of each patient should precede management decisions in individual cases.

The Greek version of the Gagging Assessment Scale in children and adolescents: psychometric properties, prevalence of gagging, and the association between gagging and dental fear.

BACKGROUND: No studies assessing the association between gagging and dental fear are available in pediatric samples. AIM: To assess the psychometric properties of the Greek version of the Gagging Assessment Scale (GAS), to explore the prevalence of gagging, and to evaluate the relationship between gagging and dental fear in a pediatric sample. DESIGN: A total of 849 8- and 14-year-old children filled out a questionnaire consisting of demographic items, the Greek version of the GAS, and the Greek Children's Fear Survey Schedule Dental Subscale (CFSS-DS); the older children also completed the Greek version of the Modified Dental Anxiety Scale (MDAS). The short form of dentist part of the Gagging Problem Assessment (GPA-de-c/SF) was used to objectively assess gagging. RESULTS: A total of 51 children (6.0%) demonstrated gagging on the GPA-de-c/SF. Children rated as gaggers on the GPA-de-c/SF had significantly higher GAS scores. There were no relationships between GPA-de-c/SF and the CFSS-DS or MDAS. The GAS ratings were significantly correlated with the CFSS-DS (rho = 0.420, P < 0.001) and MDAS (rho = 0.429, P < 0.001). The internal consistency was good (Cronbach's alpha = 0.697). CONCLUSIONS: The GAS demonstrated good psychometric properties. Dental fear was correlated with the self-report gagging assessment, but not with the objective gagging assessment.

Relationship between Child and Parental Dental Anxiety with Child's Psychological Functioning and Behavior during the Administration of Local Anesthesia.

OBJECTIVES: The aims of this study were to determine: 1) the relationship between children's psychological functioning, dental anxiety and cooperative behavior before and during local anesthesia, 2) the relationship of parental dental anxiety with all the above child characteristics. STUDY DESIGN: There was a convenient sample of 100 children (4-12 years). Child dental anxiety and psychological functioning were measured using the "Children's Fear Survey Schedule" (CFSS-DS) and the "Strengths and Difficulties Questionnaire" (SDQ) respectively. Parental dental anxiety was measured using the "Modified Dental Anxiety Scale" (MDAS). All questionnaires were completed by parents. Before and during local anesthesia, the child behavior was scored by one experienced examiner, using the Venham scale. Non-parametric tests and correlations (Mann-Whitney, Spearman's rho) were used for the analysis. RESULTS: The mean SDQ score was 10±5.6 for boys (n=60) and 8.3±4.8 for girls (n=40) (p=0.038), but there was no correlation with children's age. The mean CFSS-DS score was 33.1±11.86 and there was no correlation with age or gender. Children with higher levels in the pro-social subscale of the SDQ had significantly less anxiety and better behavior before local anesthesia. Higher mean CFSS-DS scores were significantly associated with uncooperative behavior during local anesthesia (p=0.04). There was no correlation between parents' and their children's dental anxiety, psychological functioning and behavior. 46% of the children had previous dental experience in the last 6 months. As time since the last dental treatment increased, an improvement was found in children's behavior during local anesthesia. CONCLUSIONS: Child psychological functioning was related to dental anxiety and behavior during dental appointment involving local anesthesia.

Erosive Tooth Wear and Related Risk Factors in 8- and 14-Year-Old Greek Children.

The aim of the present study was to investigate the erosive tooth wear of primary and permanent teeth and its association with related risk factors. Two groups of Greek children aged 8 (n = 329) and 14 years (n = 263) were examined in the classroom using the Basic Erosive Wear Examination (BEWE) index. Data concerning risk factors were collected using questionnaires. Dental caries (DMFS/dmfs) was also recorded. The data were analyzed using the t test, one-way ANOVA, multiple regression analysis, Fisher's exact test, and the χ2 test. In the 8-year-olds, the primary teeth showed a predominantly medium level of wear and the permanent teeth no wear. A majority of the 14-year-olds exhibited low risk levels of wear. The most frequently affected dental surface in both age groups was the occlusal surface of the mandibular posterior teeth. In the 8-year-olds, BEWE scores and the prevalence of wear in the primary teeth was influenced by gender (p = 0.020). In their permanent teeth, soft drink consumption (p < 0.0001) and preference for lemon/vinegar (p = 0.041) significantly affected wear prevalence and BEWE scores, while habitually retaining soft drinks in the mouth influenced wear prevalence (p = 0.008), risk (p = 0.004), and BEWE scores (p = 0.022). In the 14-year-olds, wear prevalence was significantly affected by the consumption of lemon-flavored candies (p = 0.016) and soft drinks (p = 0.050). BEWE scores were significantly affected by gender (p = 0.022) and soft drink consumption (p = 0.030). Gender influenced tooth wear risk in both age groups (p = 0.010 and p = 0.021, respectively). The results of this study indicate that erosive tooth wear differed between primary and permanent teeth and was influenced by gender and dietary factors.

In Vitro Inhibition of Enamel Demineralisation by Fluoride-releasing Restorative Materials and Dental Adhesives.

PURPOSE: To determine the ability of 5 contemporary fluoride-releasing restoratives and 3 fluoride-releasing adhesives to inhibit enamel demineralisation surrounding restorations, and the associations between inhibition and the levels of fluoride released from these materials. MATERIALS AND METHODS: Five fluoride-releasing restoratives (Fuji IX GP, Ketac N100, Dyract Extra, Beautifil II and Wave) and 3 fluoride-releasing adhesives (Stae, Prime & Bond NT and Fluoro Bond II) were investigated. Eight disks of each material were prepared. Fluoride release was measured daily using a fluoride-ion-selective electrode for 15 days. Twenty-four cavities for each group were restored with a restorative and an adhesive. Specimens were subjected to thermal stress and stored for 30 days in saline solution. After a 15-day pH-cycling regimen, two 150-µm-thick sections were derived from each specimen. Enamel lesion depth was measured at 0, 100, and 200 µm from each restoration's margin via polarised light microscopy. RESULTS: Of the restoratives investigated, Fuji IX GP released the most fluoride. The fluoride-releasing restoratives tested exhibited shallower enamel lesions than did the control group at all distances tested (p < 0.05). Fuji IX GP yielded significantly lower enamel lesion depth than did the other experimental materials. The depths of enamel lesions did not differ significantly when comparing restoratives applied with a fluoride-releasing adhesive with those applied with a non-fluoride-releasing adhesive. CONCLUSION: The fluoride-releasing materials tested reduced enamel demineralisation but to different extents, depending on their levels of fluoride release. Fluoride-releasing adhesives did not influence enamel lesion formation.

Molar Incisor Hypomineralization of Eight- and 14-year-old Children: Prevalence, Severity, and Defect Characteristics.

PURPOSE: To report on the prevalence, severity, defect location, and other characteristics of molar incisor hypomineralization (MIH). METHODS: Representative samples of eight- and 14-year-old children (1,179 and 1,156, respectively) in three Greek cities were examined for MIH in the classroom using European Academy of Pediatric Dentistry criteria. MIH either mild or severe included the recording of defect color and location. RESULTS: MIH prevalence was 21 percent (498 of 2,335 children), with a statistically significant difference in one city (16 percent) from the other two (23 percent, P=.007; and 23 percent, P=.002). In 46 percent of MIH cases, only permanent first molars (PFMs) were affected. MIH severity was associated with age (severe MIH eight-year-olds comprised 13 percent; 14-year-olds comprised 35 percent, P<.001) and with number of affected teeth per child (mild equals 2.44, severe equals 4.22, P<.001). The lingual surfaces of mandibular PFMs and palatal/lingual surfaces of all incisors were significantly less frequently affected (all less than 10 percent) than their buccal/labial counterparts (P<.0001). CONCLUSIONS: Predominantly mild MIH was common in children's permanent teeth, with some intracountry variation. A surface predilection of MIH opacities was clearly revealed. The severity in 14-year-olds was threefold that of eight-year-olds.

Publication bias & small-study effects in pediatric dentistry meta-analyses.

OBJECTIVES: The aim of this study was to examine the presence and extent of publication bias and small-study effects in meta-analyses (MAs) investigating pediatric dentistry-related subjects. METHODS: Following a literature search, 46 MAs including 882 studies were analyzed qualitatively. Of these, 39 provided enough data to be re-analyzed. Publication bias was assessed with the following methods: contour-enhanced funnel plots, Begg and Mazumdar's rank correlation and Egger's linear regression tests, Rosenthal's failsafe N, and Duval and Tweedie's "trim and fill" procedure. RESULTS: Only a few MAs adequately assessed the existence and effect of publication bias. Inspection of the funnel plots indicated asymmetry, which was confirmed by Begg-Mazumdar's test in 18% and by Egger's test in 33% of the MAs. According to Rosenthal's criterion, 80% of the MAs were robust, while adjusted effects with unpublished studies differed from little to great from the unadjusted ones. Pooling of the Egger's intercepts indicated that evidence of asymmetry was found in the pediatric dental literature, which was accentuated in dental journals and in diagnostic MAs. Since indications of small-study effects and publication bias in pediatric dentistry were found, the influence of small or missing trials on estimated treatment effects should be routinely assessed in future MAs.

Fluoride release and recharge abilities of contemporary fluoride-containing restorative materials and dental adhesives.

The aim of this study was to evaluate the fluoride release of five fluoride-releasing restorative materials and three dental adhesives, before and after NaF solution treatment. Five restorative materials (Fuji IX GP, GC Corp.; Ketac N100, 3M ESPE; Dyract Extra, Dentsply; Beautifil II, Shofu Inc.; Wave, SDI) and three dental adhesives (Stae, SDI; Fluorobond II - Shofu Inc.; Prime & Bond NT, Dentsply) were investigated before and after NaF solution treatment. A fluoride ion-selective electrode was to measure fluoride concentrations. During the 86-day period before NaF solution treatment, Fuji IX GP released the highest amount of fluoride among the restorative materials while Prime & Bond NT was the highest among the dental adhesives. After NaF solution treatment, Fuji IX GP again ranked the highest in fluoride release among the restorative materials while Fluorobond II ranked the highest among dental adhesives. It was concluded that the compositions and setting mechanisms of fluoride-containing dental materials influenced their fluoride release and recharge abilities.

Management of bulbous exophytic malformations of permanent mandibular incisors.

This paper presents the diagnosis and management of a rare case of bulbous exophytic malformation of three permanent mandibular incisors. An 8-year-old Caucasian girl presented with concerns on the appearance of these teeth. Medical history was noncontributory, and there was no recall of relevant past trauma. Upon clinical examination, 3 permanent mandibular incisors exhibited hard bulbous protuberances in the crown's middle and cervical areas. Radiographic examination assisted by dental computed tomography revealed that these were continuous with the tooth structure, contained no pulpal tissue, and the teeth displayed normal root development. They were excised and the teeth were restored with a thin composite facing. They remained asymptomatic with acceptable esthetics for 4 years. Scanning electron microscopy and histology of the biopsied hard tissue revealed a nonhomogeneous structure resembling anomalously intertwined enamel with predentin and dentin. The etiology of this disturbance of dental development remains unknown.

Effective treatment of self-injurious oral trauma in Lesch-Nyhan syndrome: a case report.

Lesch-Nyhan syndrome (LNS) is an X-linked disorder originating from deficiency of the enzyme hypoxanthine guanine phosphoribosyl transferase. It is characterized by neurological manifestations, including the dramatic symptom of compulsive self-mutilation, which results in destruction of oral and perioral tissues. Several drug trials have been administered to improve the severe self-destructive behaviour, with questionable effectiveness. Invasive treatment approaches, such as extraction of teeth and orthognathic surgery, have been suggested with variable success. A conservative treatment with an intraoral appliance serving to prevent oral and peri-oral self-injury is presented in this report. The patient was a 14-year-old boy demonstrating the typical LNS behaviour, including compulsive self-biting, significant loss of lip and tongue tissue, spasticity and involuntary movements. An acrylic maxillary appliance was designed and constructed with an occlusal plate raising the bite. The appliance was retained by two Adams' clasps on the first premolars, along with three ball clasps between the incisors. Fabrication, insertion, and maintenance were uncomplicated and non-stressful to the patient. Periodic recall over 3-year period has confirmed the effective healing of the oral lesions and a high level of tolerance of the appliance.

Comparison of acceptance, preference, and efficacy between jet injection INJEX and local infiltration anesthesia in 6 to 11 year old dental patients.

Needleless devices have been developed to provide anesthesia without injections. Little controlled research has examined the acceptability of needleless devices in pediatric patients. The aims of the study were to compare children's acceptance and preference for one type of needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Eighty-seven nonfearful children with no previous experience of dental anesthesia were studied using a split-mouth design. The first dental procedure was performed with the classical infiltration anesthesia. The same amount of anesthetic was administered using the INJEX needleless device in a second session 1 week later, during which a second dental procedure was performed. Patients rated their acceptance and preference for the 2 methods, and the dentist recorded data about the need for additional anesthesia. More negative experiences were reported for the INJEX method. Most (73.6%) of the children preferred the traditional method. Among the 87 treatment procedures attempted following the use of INJEX, 80.5% required additional anesthesia, compared with 2.3% of those attempted following traditional infiltration. Traditional infiltration was more effective, acceptable, and preferred, compared with the needleless INJEX.

Psychometric properties of Greek versions of the Modified Corah Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS).

BACKGROUND: A growing body of literature describes the performance of dental fear questionnaires in various countries. We describe the psychometric properties of Greek versions of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Survey (DFS) in adult Greek patients. METHODS: Greek versions of the MDAS and DFS were administered to two samples of adult dental patients. In the first sample, 195 patients attending one of three private practice dental offices in a large city in Greece completed the questionnaires in the waiting room before dental treatment. After treatment, their dentists (who did not know how the patients had answered the questionnaire) rated their anxiety during dental treatment. In the second sample, 41 patients attending a Greek university dental school clinic completed the questionnaire twice at two separate visits, in order to provide test-retest data. Cronbach's alpha was used to compute the internal consistencies, while Spearman's rho was used to compute the test-retest reliabilities. Construct validity was assessed by correlating the responses to the MDAS and DFS by Spearman's rho. Spearman's rho was also used to examine the criterion validities, by comparing the questionnaire responses with the dentists' ratings of anxiety. RESULTS: The internal consistencies for the MDAS were 0.90 and 0.92 in the two samples; for the DFS, the internal consistencies were 0.96 in both samples. The test-retest reliabilities were 0.94 for the MDAS and 0.95 for the DFS. The correlation between the two questionnaires was 0.89. The patients' responses to both questionnaires were significantly related to the dentists' ratings of their anxiety during dental treatment (both p values <0.001). CONCLUSION: The results indicate that the Greek versions of the MDAS and DFS have good internal consistencies and test-retest reliabilities, as well as good construct and criterion validities. The psychometric properties of the Greek versions of these questionnaires appear to be similar to those previously reported in other countries.