Association between eGDR and the risk of chest pain: A comparative analysis based on NHANES and CHARLS databases.

Dental fear is a prevalent and clinically significant condition that negatively influences oral health behaviours, patterns of dental attendance and treatment outcomes., , Individuals experiencing high levels of dental fear are more likely to delay or avoid dental visits, often seeking care only when pain or functional impairment becomes unavoidable, which frequently results in the need for more invasive and complex dental procedures. This avoidance–escalation cycle has been shown to contribute to poorer oral health–related quality of life and increased treatment burden for both patients and clinicians. Moreover, dental fear presents a challenge for dental professionals by complicating patient cooperation, prolonging treatment time and potentially compromising clinical outcomes. Consequently, the accurate identification and assessment of dental fear is widely recognised as an essential component of contemporary dental practice and oral health research. More broadly, recent oral health research has also highlighted the value of structured clinical and psychosocial parameters for improving prediction, comparability and clinical interpretation in dental research. Several self-report instruments have been developed to assess dental fear and anxiety in clinical and research settings. Widely used measures such as the Dental Anxiety Scale (DAS) and its modified version, the Modified Dental Anxiety Scale (MDAS), primarily focus on anticipatory anxiety related to dental visits and specific procedures, providing a brief and practical screening of overall dental anxiety levels. While these instruments are valuable for rapid assessment, they offer limited insight into the multidimensional nature of dental fear. In contrast, the Dental Fear Survey (DFS), originally developed by Kleinknecht and colleagues, was designed to capture multiple dimensions of dental fear, including avoidance behaviours, physiological arousal and fear elicited by specific dental stimuli and situations. Owing to its comprehensive structure, the DFS has been widely used in both clinical and epidemiological studies and has demonstrated robust psychometric properties across diverse populations., , However, cultural and linguistic differences may influence how dental fear is perceived and reported, underscoring the need for language-specific validation studies to ensure the reliability and validity of the instrument in different cultural contexts. Although the DFS has previously been used in Turkish populations and earlier studies have provided initial psychometric observations, a comprehensive Turkish validation study based on a systematic cross-cultural adaptation process and including content validity, pilot testing, exploratory and confirmatory factor analyses, internal consistency, test–retest reliability and convergent validity in an adult clinical dental population has remained limited. Therefore, although dental anxiety has been investigated in Türkiye using various instruments, the limited availability of a comprehensively validated multidimensional Turkish DFS has restricted both clinical assessment and research comparability. Moreover, advances in psychometric methodology emphasise the importance of systematic cross-cultural adaptation procedures, including pilot testing and evaluation of measurement properties, to ensure the validity and interpretability of self-report instruments across different languages and cultural settings. Recent oral health questionnaire validation studies have similarly emphasised the need for culturally adapted and psychometrically tested patient-reported instruments in specific clinical populations. Establishing a validated Turkish version of the DFS may also contribute to cross-cultural comparability in dental fear research and support standardised assessment in Turkish-speaking clinical and community populations. Therefore, the aim of the present study was to translate and culturally adapt the DFS into Turkish and to evaluate its psychometric properties in a clinical adult population. We hypothesised that the Turkish version of the DFS would retain a theoretically meaningful 3-factor structure consistent with the multidimensional construct of dental fear, demonstrate high internal consistency and temporal stability and show moderate-to-strong positive correlations with the Turkish version of the MDAS, supporting convergent validity. Construct validity was examined by assessing the relationship between the Turkish version of the DFS and the Turkish version of the MDAS, which has previously demonstrated acceptable validity and reliability in the Turkish population.