The children's fear survey schedule-dental subscale in Japan

Yukie Nakai, Takayuki Hirakawa, Peter Milgrom, Trilby Coolidge, Masahiro Heima, Yukako Mori, Chikako Ishihara, Noriko Yakushiji, Toshiko Yoshida, Tsutomu Shimono

Research output: Contribution to journalArticlepeer-review

97 Citations (Scopus)


Objectives: The aims of this research are to examine the reliability and validity of the Japanese version of the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS), and to examine the responses of children in the dental setting and in the community. Methods: The CFSS-DS was translated into Japanese and administered to three samples. The first sample comprised 134 child patients aged 8-15 years, of whom 100 were assigned for test-retest analysis, and the behavior of the remaining 34 additional children were rated during their dental appointments, and compared with their questionnaire results. A second sample of 532 child patients aged 8-15 years, completed the CFSS-DS and also one additional item measuring fear of returning to the dentist. A third sample of 1250 school children aged 8-15 years was surveyed using the CFSS-DS and the additional item measuring fear of returning to the dentist. Results: The Japanese version of the CFSS-DS showed good internal consistency (alpha = 0.91) and test-retest reliability (r = 0.90), as well as good criterion validity assessed by the relationship with actual child behavior (rs = 0.51). It also showed good construct validity assessed by correlation with willingness to return to the dentist. Fear levels were higher in the school sample than in the clinic sample (27.7 versus 24.6). Girls reported more fear than boys (26.2 versus 23.2 in the clinic sample, and 30.7 versus 24.8 in the school sample). Injections, choking, having a stranger touch them, and drilling were the most common fears. Factor analyses demonstrated a factor pattern similar to the results found in other cultures. Conclusion: The results suggest that the CFSS-DS is reliable and valid and operates in Japan as it does in other cultures.

Original languageEnglish
Pages (from-to)196-204
Number of pages9
JournalCommunity dentistry and oral epidemiology
Issue number3
Publication statusPublished - Jun 2005
Externally publishedYes


  • Children
  • Dental anxiety
  • Dental fear
  • Japan
  • Reliability
  • Validity

ASJC Scopus subject areas

  • General Dentistry
  • Public Health, Environmental and Occupational Health


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