Bantel David, Chmielewski Witold X, Brähler Elmar, Stöbel-Richter Yve, Zenger Markus, Weil Katharina Marilena, Berth Hendrik
Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neuroscience, Research Group Applied Medical Psychology and Medical Sociology, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Institute for Psychological Psychotherapy, University of Bochum, Bochum, Germany.
BMC Psychol. 2025 Aug 21;13(1):953. doi: 10.1186/s40359-025-03304-9.
The Dental Anxiety Scale (DAS) is a well-established instrument for assessing dental anxiety. While numerous cross-sectional studies have examined the DAS, longitudinal research investigating age-related changes, reliability, validity over time, associations with mental and physical health, and demographic determinants remains limited. Furthermore, the possibility of longitudinal changes in its factor structure has received limited attention.
In 2013/2014, N = 329 German adults (53.6% female, mean age 40.20 years) and in 2019/2020, N = 323 adults (55.7% female, mean age 47.15 years) completed questionnaires, including the DAS, Oslo Social Support Scale (OSSS-3), Health-Score (G-Score), Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder Screener (GAD-2), Short Scale for General Life Satisfaction (L-1), and oral health behavior items. DAS reliability was assessed using Cronbach's alpha and McDonald's omega, and factor structure via principal component analyses (PCA). Longitudinal dynamics were analyzed using McNemar's test. Associations between dental anxiety and independent variables were investigated using correlational analyses and Wilcoxon signed-rank tests.
DAS significantly declined from 2013/2014 (M = 9.47) to 2019/2020 (M = 9.21). Internal consistency was excellent (α/Ω = 0.93), and a correlation of dental anxiety across waves was high (rs = 0.79). PCA revealed a stable one-factor structure (2013/2014: 82.25%, 2019/2020: 82.86% explained variance). McNemar test indicated no significant changes in the proportion of subjects with or without dental anxiety over time. Higher dental anxiety was significantly correlated with lower levels of: life satisfaction, perceived influence over health, condition of health, physical and mental health, and social support in both waves (all rs ≥ 0.14; p ≤ 0.015). A significant decrease in dental anxiety over time was observed in participants with frequent tooth brushing, no indication for depression, and at least moderate social support (all z ≤ -2.07, all p ≤ 0.019).
This study provides evidence for DAS's reliability, temporal stability, and construct validity. Although dental anxiety showed a statistically significant decline it remains relatively stable for most participants. Findings indicate meaningful associations with psychosocial, behavioral, and health-related factors, supporting the potential value of interdisciplinary approaches that include psychological support in oral health care.
牙科焦虑量表（DAS）是一种成熟的评估牙科焦虑的工具。虽然众多横断面研究已对DAS进行了检验，但关于年龄相关变化、可靠性、随时间的效度、与身心健康的关联以及人口统计学决定因素的纵向研究仍然有限。此外，其因子结构的纵向变化可能性受到的关注也有限。
在2013/2014年，N = 329名德国成年人（53.6%为女性，平均年龄40.20岁），在2019/2020年，N = 323名成年人（55.7%为女性，平均年龄47.15岁）完成了问卷调查，包括DAS、奥斯陆社会支持量表（OSSS - 3）、健康评分（G评分）、患者健康问卷（PHQ - 2）、广泛性焦虑障碍筛查量表（GAD - 2）、总体生活满意度简短量表（L - 1）以及口腔健康行为项目。使用克朗巴哈α系数和麦克唐纳ω系数评估DAS的可靠性，并通过主成分分析（PCA）分析因子结构。使用麦克尼马尔检验分析纵向动态变化。使用相关分析和威尔科克森符号秩检验研究牙科焦虑与自变量之间的关联。
DAS从2013/2014年（M = 9.47）到2019/2020年（M = 9.21）显著下降。内部一致性极佳（α/Ω = 0.93），各波次间牙科焦虑的相关性很高（rs = 0.79）。PCA显示出稳定的单因子结构（2013/2014年：解释方差82.25%，2019/2020年：解释方差82.86%）。麦克尼马尔检验表明，随着时间推移，有或无牙科焦虑的受试者比例无显著变化。在两个波次中，较高的牙科焦虑均与较低水平的以下各项显著相关：生活满意度、对健康的感知影响力、健康状况、身心健康以及社会支持（所有rs≥0.14；p≤0.015）。在经常刷牙、无抑郁迹象且至少有中度社会支持的参与者中，观察到牙科焦虑随时间显著降低（所有z≤ - 2.07，所有p≤0.019）。
本研究为DAS的可靠性、时间稳定性和结构效度提供了证据。虽然牙科焦虑在统计学上显示出显著下降，但对大多数参与者来说仍相对稳定。研究结果表明与心理社会、行为和健康相关因素存在有意义的关联，支持了在口腔保健中纳入心理支持的跨学科方法的潜在价值。
