title: Development of an Orofacial Esthetic Scale in prosthodontic patients.
abstract: OBJECTIVE
  Despite the interest and need to assess orofacial esthetics in prosthodontic patients, few self-reporting instruments are available to measure this construct, and none describe how prosthodontic patients perceive the appearance of their face, mouth, teeth, and dentures. The development of the Orofacial Esthetic Scale (OES) is reported in this article, in particular its conceptual framework, how questionnaire items were generated, and the scale's measurement model.
  
  
  METHODS
  After test conceptualization, the authors solicited esthetic concerns from 17 prosthodontic patients by asking them to evaluate their own photographs. A focus group of 8 dental professionals reduced the initial number of concerns/items and decided on an item response format. Pilot testing in 9 subjects generated the final instrument, the OES. Exploratory factor analysis was performed to investigate OES dimensionality and item analysis to investigate item difficulty and discrimination in 119 subjects.
  
  
  RESULTS
  Prosthodontic patients generated an initial 28 esthetic concerns. These items were reduced to 8 preliminary representative items that were subsequently confirmed during pilot testing. Analysis supported 8 items assessing appearance: face, profile, mouth, tooth alignment, tooth shape, tooth color, gums, and overall impression, measured on an 11-point numeric rating scale (0 = very dissatisfied, 10 = very satisfied). Exploratory factor analysis found only 1 factor and high positive loadings for all items (.73 to .94) on the first factor, supporting the unidimensionality of the OES.
  
  
  CONCLUSIONS
  The OES, developed especially for prosthodontic patients, is a brief questionnaire that assesses orofacial esthetic impacts.
authors.affiliation: Centre of Oral Rehabilitation, Linköping, Sweden. Pernilla.Larsson@lio.se
authors.forename: Pernilla
authors.initials: P
authors.lastname: Larsson
authors.forename: Mike T
authors.initials: MT
authors.lastname: John
authors.forename: Krister
authors.initials: K
authors.lastname: Nilner
authors.forename: Lars
authors.initials: L
authors.lastname: Bondemark
authors.forename: Thomas
authors.initials: T
authors.lastname: List
mesh_terms: D017266:Dental Prosthesis / Q000523:psychology; D004955:Esthetics, Dental / Q000145:classification* / Q000523:psychology / Q000706:statistics & numerical data; D005145:Face / Q000033:anatomy & histology; D005163:Factor Analysis, Statistical; D017144:Focus Groups; D005881:Gingiva / Q000033:anatomy & histology; D006801:Humans; D009055:Mouth / Q000033:anatomy & histology; D010549:Personal Satisfaction; D023861:Photography, Dental; D010865:Pilot Projects; D011476:Prosthodontics; D012649:Self Concept; D012904:Smiling / Q000523:psychology; D011795:Surveys and Questionnaires; D014070:Tooth / Q000033:anatomy & histology