Inter-rater agreement between children's self-reported and parents' proxy-reported dental anxiety.

BACKGROUND: Healthcare professionals often rely on parents to provide accurate dental anxiety assessment for their children. To date no studies have reported on inter-rater agreement between children's self-reported and their parents'/guardians' proxy-reported dental anxiety in the UK. AIMS: To assess the frequency of self-reported dental anxiety in 7-16-year-old children and the inter-rater agreement between children's self-reported and parent/guardian proxy-reported dental anxiety for their children. METHODS: Data were collected prospectively from 7-16-year-old children and their parents/guardians attending two community dental clinics in Fife, Scotland (July 2012-January 2013). Dental anxiety was assessed using faces version of Modified Child Dental Anxiety Scale. Questionnaires were separately and independently completed by children and their accompanying parent or guardian. RESULTS: One hundred and thirty-two child-parent/guardian pairs participated in this study. Children's self-reported dental anxiety was 18% (n=24, 95% CI 12-25). Inter-rater agreement between children and their parent/guardian was poor for dental filling (linear weighted kappa coefficient 0.17) and tooth extraction (0.20), whereas other questions had fair inter-rater agreement (0.21-0.34). Parents' proxy-reported assessments significantly failed to recognise dental anxiety in 46% (n=11) dentally anxious children (p=0.0004). CONCLUSION: Parent/guardian proxy-reported dental anxiety differs from children's self-reported dental anxiety suggesting children should be encouraged to self-report their dental anxiety.