About the MDAS

The Modified Dental Anxiety Scale (MDAS) is a short questionnaire that dentists and researchers use to measure how anxious someone feels about dental visits. It was developed and tested by Gerry Humphris and colleagues and published in 1995.

It asks how you would feel in five situations: treatment tomorrow, sitting in the waiting room, having a tooth drilled, having your teeth scaled and polished, and having a numbing injection. Each answer scores from 1 (not anxious) to 5 (extremely anxious), so totals run from 5 to 25.

The MDAS is free to use, and its authors ask that the five questions are not changed. That's why the questions above keep their original wording, including British spellings like "anaesthetic". ("Scaled and polished" means a cleaning.)

What your score means

Score	What it means
5–10	Low. At or below the UK adult average
11–18	Moderate. More anxious than average, below the cut-off
19–25	High. The authors' cut-off for high dental anxiety, possibly dental phobia

Only the 19 or more cut-off comes from the scale's authors. The research team at the University of St Andrews calls it an approximation to guide care, not a diagnosis. The "low" and "moderate" labels are our own plain-English way to describe scores below it.

In a 2008 survey of UK adults, the average score was 10.4, and 11.6% scored 19 or more. High scores were more common in women (14.9%) than in men (8.3%). They were most common in people in their 30s (17.3%) and least common at age 70 and over (4.0%). The table under the test shows every group.

Your score can change. A good experience, a dentist you trust, or treatment for dental fear can all bring it down. If fear has kept you away and something hurts now, the Dental Emergency Checker shows how soon to be seen.

Practical ways to make visits easier

The ADA's MouthHealthy site suggests:

Tell the team. Let the receptionist, the dentist and the hygienist know you're anxious.
Ask questions. Knowing what will happen and why, even how long the numbness will last, makes it less scary.
Agree a signal, such as raising your hand, for when you need a break.
Talk about pain. If you can still feel pain with the numbing shot, say so. Your dentist can help.
Distract yourself with headphones and music or an audiobook, or keep your hands busy with a stress ball.
Use calming techniques: picture a calm place, count your breaths slowly, or relax your body one part at a time.

Talking to your dentist

Many people find it hard to put their fear into words in the chair. The My dentist plan card above turns your answers into short, clear requests. It ticks suggestions that match your answers, for example a warning before the injection if that's what worries you most. Change the ticks, add a note, then print it or show it on your phone. A good dentist will be glad to know.

If your score is high, you can also ask whether your dentist offers longer appointments, or can refer you to a service that specializes in anxious patients.

Sedation options explained

Sedation is medicine that helps you feel calm and relaxed during treatment. It's for education here: your dentist will explain what suits you and what's available. Ask about the cost too, and check what your plan pays. A UK hospital dental service (Guy's and St Thomas' NHS Foundation Trust) describes these options:

Option	What happens
Inhalation sedation	You breathe oxygen mixed with a calming gas through a small nosepiece
Oral sedation	You take a drink containing a sedative medicine
Intravenous (IV) sedation	The medicine goes through a small tube in a vein in your arm or hand
Intranasal sedation	A sedative spray goes into your nose
General anesthetic	Not sedation: you're fully asleep (controlled unconsciousness)

Therapy for dental fear

Talking therapy can help. Cognitive behavioral therapy (CBT) helps you change the thoughts and habits that keep fear going, step by step. In one UK specialist service, 79% of people referred for CBT for dental phobia went on to have dental treatment without sedation. Those who did needed an average of 5 CBT appointments first (Kani and colleagues, 2015). Some UK NHS dental hospitals, such as Guy's and St Thomas', have dental psychology services. Elsewhere, ask your dentist or doctor about a referral to a therapist who works with phobias.

How this test works

You answer the five MDAS questions exactly as published.
Each answer scores 1 to 5, and the total is the sum (5 to 25), as on the official scoring sheet.
The meter shows your total. Scores of 19 or more are marked high, using the authors' cut-off.
Your score is compared with UK adult averages from the 2008 survey (Humphris, Dyer and Robinson, 2009).
Nothing is sent anywhere. Your answers aren't put in shared links, and only your score and the date are saved, and only if you press Save score to My Smile.

The MDAS measures how you feel about dental visits. It doesn't diagnose an anxiety disorder. If fear of the dentist affects your health or daily life, talk to your dentist or doctor.

Citation, as the authors request: Humphris GM, Morrison T, Lindsay SJE. The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dental Health 1995;12:143-150.

Frequently asked questions

What is a normal score on the MDAS?

In a 2008 survey of UK adults, the average score was 10.4 out of 25, and 11.6% scored 19 or more (Humphris, Dyer and Robinson, 2009). Scores range from 5 (not anxious at all) to 25 (extremely anxious about everything).

What does an MDAS score of 19 or more mean?

The scale's authors use 19 or more to flag a highly dentally anxious person, possibly with dental phobia. The St Andrews research team says the cut-off is an approximation to guide care, not a diagnosis.

Is dental anxiety common?

Yes. About 1 in 9 UK adults (11.6%) scored 19 or more in the 2008 survey. It was more common in women (14.9%) than men (8.3%), and most common at ages 30 to 39 (17.3%).

Can dental phobia be treated?

Yes. In one UK specialist service, 79% of people referred for cognitive behavioral therapy (CBT) for dental phobia went on to have dental treatment without sedation, after an average of 5 CBT appointments (Kani et al., 2015). Sedation is another option for some treatments.

Should I tell my dentist I'm anxious?

Yes. The ADA suggests telling the receptionist and the dental team about your anxiety, asking questions, and agreeing a signal, such as raising your hand, for when you need a break. The printable plan above helps you say it.

Sources

Humphris GM, Morrison T, Lindsay SJE. Community Dental Health 1995;12:143-150. The Modified Dental Anxiety Scale: validation and United Kingdom norms. 1995. Questions used unaltered, as the authors request. Accessed October 26, 2026.
University of St Andrews, Dental Anxiety research group. Frequently asked questions – Modified Dental Anxiety Scale. Accessed October 26, 2026.
Dental Fear Central (reproduction of the MDAS form and scoring sheet). Modified Dental Anxiety Scale (MDAS). Accessed October 26, 2026.
Humphris GM, Dyer TA, Robinson PG. BMC Oral Health 2009;9:20. The modified dental anxiety scale: UK general public population norms in 2008 with further psychometrics and effects of age. 2009. Accessed October 26, 2026.
American Dental Association (MouthHealthy). Anxiety: 3 Ways to Stop Fearing the Dentist. Accessed October 26, 2026.
Guy's and St Thomas' NHS Foundation Trust. Sedation options for dental treatment - Overview. reviewed May 2026. Accessed October 26, 2026.
Guy's and St Thomas' NHS Foundation Trust. Dental psychology - Dental anxiety support. Accessed October 26, 2026.
Kani E, Asimakopoulou K, Daly B, et al. British Dental Journal 2015;219(10):501-506. Characteristics of patients attending for cognitive behavioural therapy at one UK specialist unit for dental phobia and outcomes of treatment. 2015. Accessed October 26, 2026.

Last reviewed October 26, 2026 by the Dental Health Time editorial team, against the sources above. How we review.

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