This measure provides an initial estimate of how far a case deviates from the normal and the differences between scores before and after treatment. This difference reflects the degree of improvement thereby providing a quantitative and reproducible measure of the score of success or failure of treatment.

It is often desirable to use the same instrument to measure treatment need and treatment outcome. Though often the same instrument is used to assess the treatment need and treatment outcomes in children managed for dental fear, the instruments were however not designed or validated for that purpose. At best, the instrument measures the degree of residual treatment but this does not sufficiently assess significant differences in treatment efficacy.

Psychological measuring scales which have clustered items based on factor analytic techniques and not just the use of conceptual or logical grouping may help in assessing the pre and post theurapeutic effects of dental fear reduction measures. The CFSS-DS and the DFSS-SF may not be ideal for this purpose as they measure only one dimensional construct of dental fear and uses score summaries for assessing levels of dental fear. The possible limitation of the use of psychometric scales with score summation was highlighted by Folayan and Idehen⁵⁴.

An ideal tool for measuring treatment outcome must therefore be a numerical measure obtained through the measure of dental fear traits that are selected based on their potential for causing psychosocial handicap. It must be able to rank dental fear causing items objectively and reliably. This could possibly be so through the use of a mathematical formula for the estimation of societal norms for dental fear there by differentiating between handicapping and non handicapping dental fear.

Such a developed measure should be used within the context of specialized practice and it could provide the means to compare treatment threshold in different countries thereby serving as a basis for quality assurance standards in the management of dental fear in children. This aspect is important because of the possible effect of culture on dental fear and its expressions⁵⁵.

The various existing measures for assessing different aspects of dental fear have served various research purposes. However, their uses as measures to determine treatment need and treatment outcomes are limited. There is therefore a need to develop culturally sensitive instruments which would enhance the objective assessment of treatment need and treatment outcomes of dental fear in children. Such instruments would help in effectively determining the efficacy of various treatment modalities for dental fear in children.