The Surgical Dental Anxiety Scale (SDAS)

Dental anxiety is a prevalent issue in society and national surveys show it to be rising. As a result, strain on sedation services continues to grow. To accommodate this, there is a need to streamline services to ensure that patients who have a clinical need for sedation are able to receive it. The Index of Sedation Need (IOSN) has been developed as a means of distinguishing sedation need from demand, enabling appropriate assessment and selection. NHS England recommends its use and the Getting It Right First Time programme has incorporated it into hospital dentistry pathways for sedation. However, many patients have sedation or require it for dental extractions, yet the Modified Dental Anxiety Scale (MDAS) component of the IOSN does not take this into account. While the MDAS is an effective tool for assessing anxiety of general dental treatment, it is not specialty- or procedure-specific and may underestimate anxiety relating to dental extractions. Consequently, the suitability of its use has been called into question. This paper explores the need for a procedure-specific dental anxiety scale for use in oral surgery and outlines a proposal for a suitable model: the Surgical Dental Anxiety Scale (SDAS).