Dentists' use of validated child dental anxiety measures in clinical practice: a mixed methods study

Background: Assessing anxiety is an important part of the assessment of a child presenting for dental treatment; however, the use of dental anxiety scales in practice is not well-documented. Aims: To introduce child dental anxiety scales, and to monitor the extent to which dentists used them; to explore the experience and views of dentists regarding anxiety assessment. Design: A mixed-methods design was employed. Method: A protocol for child anxiety assessment was introduced to paediatric dentists in Eastman Dental Hospital. After 6 months, 100 patient files were audited to examine compliance with the protocol. Fourteen dentists were interviewed to explore their experience and views regarding anxiety assessment. Results: Only five patients were assessed using the scales. Thematic analysis of the dentist interviews revealed three themes: ‘Clinical observations and experience: The gold standard’; ‘Scales as an estimate or adjunct’; and ‘Shortcomings and barriers to using scales’. Conclusions: The dentists in our study did not use anxiety scales, instead they rely on their own experience/judgement. Therefore, scales should be recommended as an adjunct to judgement. Brief scales are recommended as clinicians lack time and expertise in administering anxiety questionnaires. Advantages of using scales and hands-on experience could be incorporated more in undergraduate training