Association of depression and anxiety with different aspects of dental anxiety in pregnant mothers and their partners

Satu M. Lahiti, Mimmi M. Tolvanen, Gerald Michael Humphris, Ruth Freeman, Kari Rantavuori, Linnea Karlsson, Hasse Karlsson

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
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The aim was to confirm the factor structure of Modified Dental Anxiety Scale (MDAS) and to investigate whether the association of these factors with general anxiety and depression varied across gender.


The FinnBrain Birth Cohort Study ( data from the first collection point at gestational week 14 were used. Of the invited participants (n = 5790), 3808 (66%) expectant mothers and 2623 fathers or other partners of the mother agreed to participate, and 3095 (81.3%) mothers and 2011 (76.7%) fathers returned the self‐report questionnaire. Dental anxiety was measured with the MDAS, general anxiety symptoms with Symptom Checklist‐90 (anxiety subscale) and depressive symptoms with the Edinburgh Postnatal Depression Scale. Multiple group confirmatory factor analysis (MGCFA) was conducted to test the equivalence of the factor structure and multiple group SEM (MGSEM) to test the configural invariance (unconstrained model) and metric invariance (structural weights model), across genders.


Of those consenting, 3022 (98%) women and 1935 (96%) men answered the MDAS. The MGCFA indicated good convergent validity for the two‐factor model for MDAS, but somewhat low discriminant validity (factors demonstrated 72% shared variance). The MDAS items loaded clearly higher for the assigned factor than to the other factor (differences in loadings >0.2), indicating that the 2‐factor model has merit. According to the final MGSEM model, anxiety symptoms were directly related to anticipatory dental anxiety, but not to treatment‐related dental anxiety.


When assessing dental anxiety with MDAS, considering also its two factors may help clinicians in understanding the nature of patient's dental anxiety.

Original languageEnglish
JournalCommunity Dentistry and Oral Epidemiology
VolumeEarly View
Early online date6 Dec 2019
Publication statusE-pub ahead of print - 6 Dec 2019


  • Dental anxiety
  • Depression
  • General anxiety
  • Structural equation modelling
  • FinnBrain
  • Pregnant mothers


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