Psychometric Properties of Croatian version of the Orofacial Esthetic Scale

Objectives: To develop a Croatian version of the Orofacial Esthetic Scale (OES) and test the psychometric properties. Methods: OES is the 8-item instrument for measuring self-reported orofacial esthetics in patients with prosthodontics concerns. The questionnaire was designed to be used as a stand-alone instrument to measure direct esthetic impacts. The English version of the OES (0-10) was translated into Croatian language according to the accepted methods(forward-backward method). The original 11 point scale, as well as the 5 point scale (1=unsatisfactory, 5=excellent) were used. Convergent validity was tested on 126 subjects, and discriminative validity on the same subjects divided into 4 groups: patients esthetically normal (n=25), patients esthetically impaired (n=42), controls esthetically normal (n=37), and controls esthetically impaired (n=22). Test-retest reliability was tested on 43 subjects. Responsiveness was tested on 32 esthetically impaired patients (P-EI) who received prosthodontic treatment. Results: Additional explanation was added to the first two items of the OES. Convergent validity was confirmed by the association between the OES scores and the self-reported oral esthetics and the 3 OHIP questions related to esthetics (correlation coefficients ranged from 0.734 to 0.811, P<0.001). Discriminative validity showed the results as predicted. Test-retest reliability showed high intraclass correlation (0.79-0.95) and no significant differences between the two administrations of the 1-5 OES scale (P>0.05). The 0-10 OES scale showed significant differences for the third and the eighth question (P<0.01). Internal consistency showed high Cronbach α (0.802-0.962). Responsiveness was confirmed by a significant difference between the baseline and follow-up (P<0.001) and a high effect size. Conclusions: Psychometric properties of OES-CRO render the instrument suitable for the assessment of esthetics in Croatia. We recommend changing the first two items by adding explanation that questions are related to the lower third of the face and the five point scale for rating.