Open, dependency-free scoring for validated dental-anxiety instruments — the Modified Dental Anxiety Scale (MDAS), Corah's Dental Anxiety Scale, and the child faces MCDASf — with multilingual item sets, published cut-offs, and a live web demo.
dental anxiety · MDAS · Corah DAS · MCDASf · dental phobia · psychometrics · screening · oral health · patient-reported outcome · odontophobia
Important
OraCalm is an educational and research aid, not a diagnostic device. It computes published scoring keys for screening only. It does not diagnose dental anxiety or phobia, stores no personal data, and never replaces clinical judgement or the original instruments' manuals.
Contents · Why · Instruments · Install · Python API · CLI · Web demo · Provenance & licensing · Publishing & DOI · Cite · References & prior work
Dental anxiety is common, frequently under-detected, and measured with well-validated questionnaires — yet those instruments live in PDFs and journal appendices, and every project re-implements the scoring by hand. OraCalm encodes the scoring keys, cut-offs, and interpretation bands of widely used dental-anxiety instruments once, correctly, and with citations, as a small dependency-free Python library plus a clean web demo.
The scoring keys and cut-offs are facts; item wording is reproduced from the published instruments with attribution (see Provenance & licensing).
| id | Instrument | Population | Items | Range | Validated cut-off | Languages | Source |
|---|---|---|---|---|---|---|---|
mdas |
Modified Dental Anxiety Scale | Adults | 5 | 5–25 | ≥19 high anxiety / possible phobia | EN · TR · FA | Humphris et al. 1995 |
corah_das |
Corah's Dental Anxiety Scale | Adults | 4 | 4–20 | ≥13 clinically anxious; ≥15 severe | EN | Corah 1969 |
mcdasf |
Modified Child Dental Anxiety Scale (faces) | Children ~8–15y | 8 | 8–40 | no single agreed cut-off | EN | Howard & Freeman 2007 |
pip install oracalm
# or, from a clone:
pip install -e .import oracalm
# Score a completed MDAS (one integer per item, in order)
result = oracalm.score("mdas", [3, 3, 4, 2, 5])
print(result.total) # 17
print(result.band_label) # 'Moderate dental anxiety'
print(result.flags) # [] (below the ≥19 cut-off)
# A high-anxiety MDAS
oracalm.score("mdas", [4, 4, 4, 4, 3]).flags
# ['>=19: High dental anxiety / possible dental phobia']
# Interpret a raw total without re-scoring
oracalm.interpret("corah_das", 15)["label"] # 'Severe anxiety (possible dental phobia)'
# Discover what's available
oracalm.list_instruments()Every ScoreResult carries the total, the min/max range, the interpretation band, cut-off flags, and a human-readable interpretation, and serialises with .to_dict().
oracalm list # list instruments
oracalm show mdas --lang tr # print the questionnaire (Turkish)
oracalm score mdas 3 3 4 2 5 # score (space- or comma-separated)
oracalm score das 4,4,4,3$ oracalm score das 4,4,4,3
Corah's Dental Anxiety Scale (Corah DAS)
Total: 15 / 20 (range 4-20)
Band: Severe anxiety (possible dental phobia)
Flags:
- >=13: Clinically significant anxiety (per some references)
- >=15: Severe anxiety / possible dental phobia
Source: Corah NL (1969). Development of a dental anxiety scale. Journal of Dental Research.
A self-contained, mobile-friendly demo lives in demo/index.html — pick an instrument, choose a language (MDAS: EN/TR/FA, with right-to-left support for Persian), tap through the items, and watch the score, severity band, and cut-off flags update live. No data leaves the page. Open the file directly, or host it on GitHub Pages.
The interface follows Apple's fluid-design principles — instant press feedback, calm critically-damped motion, translucent materials, optical typography, and full prefers-reduced-motion / -transparency / -contrast support — kept deliberately gentle for an anxiety-sensitive context.
Each instrument is defined declaratively (see oracalm/instruments.py) as: item stems, response options, total-score range, interpretation bands that tile the whole range, validated cut-offs, and a full citation. The engine (oracalm/core.py) validates that every response is one of the item's allowed values and that the count matches, sums the responses, resolves the interpretation band, and evaluates cut-offs. The test suite proves that each instrument's achievable min/max equals its declared range and that the bands cover the range with no gaps or overlaps.
The software is MIT-licensed. The instruments are the intellectual property of their authors and are reproduced here for educational/research use with attribution:
- MDAS — made freely available for use by the authors provided the source is cited (official MDAS site, University of St Andrews). English wording is canonical; the Turkish and Persian strings are convenience translations and should be checked against the officially validated versions before clinical use.
- Corah's DAS (1969) — a classic, widely reproduced 4-item scale.
- MCDASf (Howard & Freeman 2007) — faces version of the Modified Child Dental Anxiety Scale (Wong et al. 1998).
If you plan commercial redistribution, verify the reuse terms of each instrument with its authors/publisher.
- IDAF-4C+ (Index of Dental Anxiety and Fear) once reuse terms are confirmed.
- Additional validated language sets (contributions welcome, with a citation per translation).
Maintainer notes for releasing OraCalm live on GitHub, PyPI, and Zenodo — a full copy-paste walkthrough — are in PUBLISHING.md. In short: push to GitHub, upload the assets/social-preview.png as the repo's social preview, set the GitHub About description and topics for discoverability, publish to PyPI, then connect Zenodo and tag a Release to mint a citable DOI (done for v0.1.0 — see the DOI badge above).
If OraCalm supports your work, please cite the software (see CITATION.cff; v0.1.0 is archived at doi:10.5281/zenodo.21704085) and the original instrument(s) you used (see below).
Instrument sources were retrieved via PubMed; DOIs/PMIDs are linked. Please cite the original instrument(s) alongside OraCalm.
Methods and instruments it implements
- Humphris, G.M., Morrison, T. & Lindsay, S.J.E. (1995). The Modified Dental Anxiety Scale: validation and United Kingdom norms. Community Dental Health 12(3):143–150. PMID 7584581 (no DOI)
- Corah, N.L. (1969). Development of a dental anxiety scale. Journal of Dental Research 48(4):596. doi:10.1177/00220345690480041801
- Corah, N.L., Gale, E.N. & Illig, S.J. (1978). Assessment of a dental anxiety scale. Journal of the American Dental Association 97(5):816–819. doi:10.14219/jada.archive.1978.0394
- Wong, H.M., Humphris, G.M. & Lee, G.T.R. (1998). Preliminary validation and reliability of the Modified Child Dental Anxiety Scale. Psychological Reports 83(3 Pt 2):1179–1186. doi:10.2466/pr0.1998.83.3f.1179
- Howard, K.E. & Freeman, R. (2007). Reliability and validity of a faces version of the Modified Child Dental Anxiety Scale. International Journal of Paediatric Dentistry 17(4):281–288. doi:10.1111/j.1365-263X.2007.00830.x
Validated translations (check the Turkish and Persian MDAS item sets against these)
- Tunc, E.P. et al. (2005). Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population. Community Dentistry and Oral Epidemiology 33(5):357–362. doi:10.1111/j.1600-0528.2005.00229.x
- Ilgüy, D. et al. (2005). Reliability and validity of the Modified Dental Anxiety Scale in Turkish patients. Journal of International Medical Research 33(2):252–259. doi:10.1177/147323000503300214
- Lin, C.-Y. et al. (2021). Psychometric testing of the Modified Dental Anxiety Scale among Iranian adolescents during COVID-19 pandemic. European Journal of Investigation in Health, Psychology and Education 11(4):1269–1279. doi:10.3390/ejihpe11040092
Evidence that motivated it (multilingual support)
- Höglund, M. et al. (2024). Cross-cultural adaptation and validation of the Swedish version of the Modified Dental Anxiety Scale. Acta Odontologica Scandinavica 83:666–671. doi:10.2340/aos.v83.42436
- Enshaei, Z., Kaji, K.S. & Saied-Moallemi, Z. (2024). Development and validation of the Iranian version of the Children's Experiences of Dental Anxiety Measure (CEDAM). Clinical and Experimental Dental Research 10(1):e830. doi:10.1002/cre2.830
Planned instrument (see Roadmap)
- Armfield, J.M. (2010). Development and psychometric evaluation of the Index of Dental Anxiety and Fear (IDAF-4C+). Psychological Assessment 22(2):279–287. doi:10.1037/a0018678
Issues and pull requests welcome — especially validated translations (please include a citation) and additional validated instruments. Please keep the library dependency-free and add tests for any new instrument.
MIT © 2026 Hossein Boustani Hezarani