Measuring patients' orofacial appearance: Validity and reliability of the English-language Orofacial Esthetic Scale

Daniel R. Reissmann, Mike T. John, Chris J. Enstad, Patricia A Lenton, Ira Sierwald

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients. Methods: In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items’ correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument's internal consistency by means of computing Cronbach α and average interitem correlation. Results: All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale's internal consistency was excellent. Conclusion: This study found that the OES-E has sufficient psychometric properties to characterize dental patient's global assessment of orofacial appearance. Practical Implications: The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients.

Original languageEnglish (US)
Pages (from-to)278-286
Number of pages9
JournalJournal of the American Dental Association
Issue number4
StatePublished - Apr 2019

Bibliographical note

Funding Information:
Research reported in this publication was supported by award R01DE022331 from the National Institute of Dental and Craniofacial Research, National Institutes of Health.

Publisher Copyright:
© 2019 American Dental Association


  • Orofacial esthetics
  • instrument development
  • instrument translation
  • psychometric evaluation
  • questionnaire


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