Appraisal of behavioral measurement techniques for assessing dental anxiety and fear in children: a review

The aim of this article is to review and evaluate behavioral and physiological measurement techniques frequently used to assess dental anxiety and fear in children. Attention is given to the data collected, the empirical findings obtained, and the availability of normative data. The main focus, however, is on the reliability and validity. Results show that all questionnaires are open to criticism. Of the behavioral measures, Melamed's Behavior Profile Rating Scale is to be preferred to Frankl's Rating Scale, Venham Rating Scales, and Visual Analogue Scales. The main reasons are that Melamed's BPRS measures the behavior of the child more precisely and that it has superior psychometric properties. Furthermore, because of their practical, conceptual, and psychometric problems, physiological measures at this stage are found to be less appropriate for assessing dental fear in children. It is concluded that a behavioral measure is not always the ideal, but often the only available technique for assessing dental fear in children.