Quintessence Int. 2021 Mar 3;52(4):360-373. doi: 10.3290/j.qi.a45603.
Objectives: The prevalence of "dental anxiety" (DA) is often underestimated and numerous diagnostic methods are available for dental practitioners. It is difficult to differentiate between a dental phobia requiring an interdisciplinary approach and DA, which can be managed by dental practitioners alone. The appropriate use of diagnostic tools is key for the successful management of highly anxious and/or phobic patients. The aim was to provide a guideline to recognize dental fear and to differentiate DA from patients who are highly anxious or even have a phobia. Data sources: In total, 8,929 articles that were selected for the development of the German guidelines for "Dental anxiety in adults" in PubMed, Web of Science, Embase, and MedPilot were filtered for diagnosis of DA disorder. The focus for this review was on the use of scales to measure DA levels. The methods and tools used in the 51 reviewed articles to assess DA levels were evaluated in terms of their practicability and suitability in daily practice to differentiate between phobia (ie, DA disorder) and nonpathologic anxiety. In addition, the internal consistency (Cronbach alpha) of the questionnaires/tools was determined. Conclusion: All identified DA questionnaires validated in the German language had an acceptable to excellent internal consistency (0.7 to 0.986). The only validated questionnaire-free method was galvanic skin reaction measurement. For the assessment of DA and diagnosis of a DA disorder in adults, the survey by means of any suitable questionnaire or even several questionnaires in combination with a behavioral observation of the patient is currently the method of choice.
“牙科焦虑”（DA）的患病率常常被低估，并且有许多诊断方法可供牙科医生使用。很难区分需要跨学科方法治疗的牙科恐惧症和仅由牙科医生管理的 DA。正确使用诊断工具是成功管理高度焦虑和/或恐惧症患者的关键。目的是提供一种识别牙科恐惧的指南，并将 DA 与高度焦虑甚至有恐惧症的患者区分开来。
总共从 PubMed、Web of Science、Embase 和 MedPilot 中筛选了 8929 篇文章，这些文章被选中用于制定德国《成人牙科焦虑指南》，以诊断 DA 障碍。这篇综述的重点是使用量表来测量 DA 水平。评估了 51 篇综述文章中用于评估 DA 水平的方法和工具在日常实践中的实用性和适用性，以区分恐惧症（即 DA 障碍）和非病理性焦虑。此外，还确定了问卷/工具的内部一致性（Cronbach alpha）。
在德语中验证的所有确定的 DA 问卷都具有可接受至极好的内部一致性（0.7 至 0.986）。唯一经过验证的无问卷方法是皮肤电反应测量。对于成年人的 DA 评估和 DA 障碍的诊断，目前通过任何合适的问卷甚至结合对患者行为的观察进行调查是首选方法。
