Validity and Reliability of the Brazilian Version of the Children’s Experiences of Dental Anxiety Measure (CEDAM)

Objective: To test the validity and reliability of the Brazilian Portuguese version of the Children's Experiences of Dental Anxiety Measure (CEDAM). Material and Methods: The sample consisted of 80 pairs of parents and 9 to 12-year-old students at a public school in Ubá, Brazil. Children self-applied the CEDAM, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Child Perceptions Questionnaire (CPQ8-10/CPQ11-14), and were clinically evaluated at school. Parents were interviewed about the child's dental history, the Corah's Dental Anxiety Scale, and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Criterion validity was assessed using the Mann-Whitney/Spearman's correlation; construct discriminant validity was evaluated using the Mann-Whitney/Kruskal-Wallis test; construct convergent validity was examined using Spearman's correlation; and predictive validity was assessed using multiple logistic regression. The reliability was calculated by Cronbach's alpha and McDonald's omega coefficients. Results: About 80% had already been to the dentist. Overall, highly fearful children had higher CEDAM mean scores than those who were less afraid, demonstrating criterion validity. In CPQ8-10 global ratings, those reporting "regular" oral health had the highest CEDAM scores compared to those reporting "very good", showing discriminant validity. For convergent validity, the CEDAM score was positively correlated with the CPQ8-10 emotional well-being domain. Moreover, significant positive correlations were observed between CEDAM scores and P-CPQ total scores and P-CPQ emotional well-being domain scores. The predictive validity was indicated by the greater chance that younger children with previous experience of dental visits, who had avoided and cried during dental treatment, presented higher CEDAM scores. Cronbach's alpha of 0.93 indicated almost perfect internal consistency of the CEDAM. Conclusion: The Brazilian Portuguese version of CEDAM proved to be valid and reliable for application in 9 to 12-year-old children. Dental anxiety is more likely to be observed in younger children who have visited the dentist, avoided, and cried during dental treatment.