Exploring the Variations in the Use of Modified Dental Anxiety Scale (MDAS) in Literature: A Survey of Studies Published from 2014 to 2023

Objectives: Modified Dental Anxiety Scale (MDAS) is a frequently used psychometric tool to evaluate the dental anxiety level of dental patients or the general population. However, it was largely unclear if MDAS was consistently administered in the original format in the academic literature. This work aimed to survey the literature published in the last 10 years to reveal the current usage of MDAS.

Methods: Web of Science and Scopus were queried to identify papers that mentioned the use of MDAS.

Results: Among a total of 260 analyzed papers, 101 papers included comprehensive information regarding both the questions posed and the response format employed. Two papers only used an explicitly renamed MDAS with modified contents. Among the 258 papers that used MDAS that were supposed to be standardized, many discrepancies from the original version were discovered. There were only 39 papers that strictly followed the recommended scoring scheme: if a participant had a score of ≥ 19, he or she might be highly dentally anxious. Notable modifications included the use of a cut-off score different from the original recommendation, the use of multiple cut-off scores, modifications of the response format or descriptors, and modifications to the question items especially adding extra questions.

Conclusions: These modifications would create confusion when researchers and clinicians tried to compare data across studies. Researchers are recommended to administer MDAS in its original format.