What is a Dental Anxiety Scale?

What is a Dental Anxiety Scale?

It’s bad enough to be afraid of the dentist or of needles, but being unable to explain it to your dentist can be even worse. All you may know is that you’re terrified to go your appointment, break out into a cold sweat when you get there, and can’t sleep before an appointment. When you meet your dentist for the first time, it’s not always easy to say those things.

Thankfully many offices have tools to help you discuss your fears and anxieties about going to the dentist. The most common option for dentists to use is a dental anxiety scale. These scales, along with other types of assessments, ask you to answer a few simple questions with your most honest reaction. From there, your dentist will have a better idea of what triggers your fear and how to help.

Corah’s Dental Anxiety Scale

Corah’s Dental Anxiety ScaleThe Corah’s Dental Anxiety Scale was developed in 1969 by Dr. Norman L. Corah. It’s a simple four question survey with five possible answers for a patient to select. Each answer has a score, and the total score tells the dentist how anxious you may be. Anything between 9 and 12 indicates moderate anxiety that can likely be managed. Thirteen to fourteen indicates high anxiety. The next level is 15-20 and lets the dentist know you have severe anxiety, maybe even a phobia, that might require the help of a mental health professional.

The exact questions on Corah’s Dental Anxiety Scale are:

  1. If you had to go to the dentist tomorrow for a check-up, how would you feel about it?
  2. When you are waiting in the dentist’s office for your turn in the chair, how do you feel?
  3. When you are in the dentist’s chair waiting while the dentist gets the drill ready to begin working on your teeth, how do you feel?
  4. Imagine you are in the dentist’s chair to have your teeth cleaned. While you are waiting and the dentist or hygienist is getting out the instruments which will be used to scrape your teeth around the gums, how do you feel?

Dental Concerns Assessment

Dental Concerns AssessmentIn 1993, Corah’s Dental Anxiety Scale received an update of sorts thanks to J.H. Clarke and S. Rustvold from the Oregon Health Sciences University School of Dentistry . The original questions were left alone, but a second assessment was added to help dentists and patients figure out which procedures might cause the most anxiety. Twenty-six potential concerns were listed with four selections for the patient to assess their levels of concern: low, medium, high, and don’t know.

As you can imagine there are a lot of things that a dentist might need to do that can cause anxiety. The sound of the drill, smells, and needles are just a few concerns on the list. Others include not being listened to, feeling out of control, and even the number of appointments you need. Patients also have the option to list anything not included in the assessment.

Modified Dental Anxiety Scale

Modified Dental Anxiety ScaleThe Modified Dental Anxiety Scale or MDAS was developed by Professor Gerry Humphris in 1995 at the University of St. Andrews in Scotland. It used the Corah’s Dental Anxiety Scale as it’s base and made changes and improvements to the original. The language was simplified for patients. They added a fifth question to ask about needle injections, a very common fear. All the questions became a little shorter and easier to understand in the modification.

Why might the MDAS be used over the Corah’s Dental Anxiety Scale? It’s nearly as widely known and can create accurate scores like the original. For patients, though, it’s also quicker to take since the questions have been simplified. Whether your dentist uses one over the other, the outcome is the same – finding out how fearful you are and trying to find ways to help you combat that anxiety.

Dental Fear Survey

Some dentists and researchers didn’t love the simple dental anxiety scales. They felt it didn’t give enough information to a dentist when working with a patient and missed some very real anxieties. In 1973, Professor Ronald Kleinknecht developed a 20 question survey to use in conjunction with a dental anxiety scale or in place of it. It was an original or alternative version of the assessment added in 1993 to the Corah’s Dental Anxiety Scale.


Not every patient needs to use a dental anxiety scale or take a survey. Some patients aren’t afraid at all and others know exactly what makes you most nervous. When you’re finding it difficult to explain to your dentist why you’re afraid, a dental anxiety scale helps you start the conversation. It’s also a good tool to let your dentist know if you may benefit from available sedation dentistry methods and other options to help you get the dental care you need.