Inclusive Modified Dental Anxiety Scale-Patients With Special Needs

This study aimed to develop and validate an inclusive version of the Modified Dental Anxiety Scale (I-MDAS) for patients with special needs (PSN), and to explore the relationship between sociodemographic and clinical factors with dental anxiety scores among this population. The I-MDAS integrated five short video clips with voice narration and subtitles based on the original MDAS items, assessed using a five-face rating scale to accommodate patients with hearing, visual, or mild intellectual disabilities. Ten experts evaluated face and content validity using the Face Validity Index (FVI) and Content Validity Index (CVI). A cross-sectional study was conducted on 50 PSN (≥18 years) with minimal to moderate intellectual disability and Venham behaviour rating scores of 0-2 attending the Special Care Dentistry Clinic, Universiti Malaya. Ethical approval was obtained from the Faculty of Dentistry Medical Ethics Committee (FDMEC). Data analysis included Cronbach’s alpha, Chi-square, Kruskal-Wallis, and Spearman’s correlation tests, with significance set at p < 0.05. The I-MDAS demonstrated excellent face and content validity (FVI = 0.95, CVI = 0.97) and high reliability (Cronbach’s alpha = 0.81). No statistically significant associations were found between age, sex, education level, medical history, or special care category and dental anxiety scores. The I-MDAS is a valid, reliable, and accessible tool for assessing dental anxiety in PSN, promoting equitable evaluation in special care settings. No significant correlations were found with the sociodemographic and clinical factors, with the small sample size as a limitation.