Development of the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+): Dental anxiety and concomitant factors in pediatric dental patients

B. Buldur, J. M. Armfield

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Objective: The aim of this study was to develop the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+) and also to explore factors associated with dental anxiety in clinical pediatric dental patients (PDPs). Study Design: The study sample consisted of 421 PDPs aged 12-14, 104 of whom were selected for test-retest analysis. The psychometric evaluation included linguistic validity, exploratory factor analysis, reliability by internal consistency (Cronbach’s alpha) and test-retest reliability (intra-class correlation coefficient, ICC). Construct validity was tested by comparing a commonly used instrument, the Children’s Fear Survey Schedule Dental Subscale (CFSS-DS). Associations between parental dental anxiety, frequency of dental visits, dental caries, dental visit behaviour and children’s dental anxiety were also examined. Results: The Turkish version of the IDAF-4C demonstrated good internal consistency (Cronbach’s alpha α=.96) and test-retest reliability (ICC=.87). Factor analysis showed a fit IDAF-4C model with a single factor, 8 items. Dental anxiety scores were significantly correlated with all measured variables (p<0.001). Girls showed significantly higher dental anxiety scores than boys (p<0.05). Conclusions: This study suggests that the Turkish version of the IDAF-4C+ is a valid and reliable instrument for assessing dental anxiety and fear in Turkish children.

Original languageEnglish
Pages (from-to)279-286
Number of pages8
JournalJournal of Clinical Pediatric Dentistry
Issue number4
Publication statusPublished or Issued - 1 Jul 2018
Externally publishedYes


  • Assessment
  • Cross-cultural adaptation
  • Dental anxiety
  • Exploratory factor analysis
  • Pediatric dental patients

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dentistry(all)

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