The aim of this study was to translate the Oral Health Impact Profile (OHIP) into Swedish and evaluate the reliability and validity of the Swedish version (OHIP-S). The OHIP is a 49-item, self-administered questionnaire divided into seven different subscales. The original version in English was translated into Swedish, accompanied by back-translation into English, after which the Swedish version was revised. A total of 145 consecutive patients participated and answered a questionnaire. The patients comprised five clinically separate groups: temporomandibular dysfunction (TMD) (n=30), Primary Sjögren’s Syndrome (SS) (n=30), burning sensation and pain in the oral mucosa (Oral mucosal pain, OMP) (n=28), skeletal malocclusion (Malocclusion) (n=27), and healthy dental recall patients (Controls) (n=30). The TMD group and the Control group participated in a test-retest procedure. The internal reliability of each subscale was calculated with Cronbach’s alpha and found to be high and to range from 0.83-0.91. The stability (test-retest) of the instrument, calculated using the intraclass correlation coefficient, ranged from 0.87-0.98. The construct validity of OHIP-S was compared with subscales of the Symptom Check List (SCL-90) (rho 0.65) and the Jaw Function Limitation Scale (JFLS) (rho 0.76) and analyzed with Spearman’s correlation coefficient. Convergent validity was evaluated by comparing OHIP with self-reported health using Spearman’s correlation coefficient and was found to be acceptable (rho 0,61). In the evaluation of the discriminative ability of the instrument, significant differences were found in the total OHIP-S score between the controls and the four other groups (P < 0.001). We conclude that the reliability and validity of OHIP-S is excellent. The instrument can be recommended for assessing the impact of oral health on masticatory ability and psychosocial function.

Aims: To develop the Jaw Functional Limitation Scale (JFLS), comprising 3 constructs and a global scale, based on a preliminary instrument, and to investigate content validity of the overall functional limitation construct, reliability, and generalizability. A temporomandibular disorders (TMD) patient group, compared to other diagnostic groups, was hypothesized to report futher limitation in each of the 3 new proposed constructs. Methods: One hundred thirty-two consecutive patients from 5 diagnostic groups (TDM, primary Sjögren syndrome, burning mouth syndrome, skeletal malocclusion, and healthy controls) participated in a known-groups validity design. Fifty-two jaw functional limitation items were identified by an expert panel for content validity. Rasch methodology was used for item reduction and assessment of model fit. The instrument was retested 1 to 2 weeks later. Results: Three constructs (mastication, vertical jaw mobility, and emotional and verbal expression) comprising a total of 20 items were identified along with a global scale (the JFLS-20), and each exhibited excellent psychometric properties with respect to modeled variance, item fit, reliability, and internal consistency. The psychometric properties of each construct remained satisfactory when analyzed separately among the 5 diagnostic groups. Temporal stability was satisfactory. A shorter 8-item form (JFLS-8) also proved useful for assessing global functional jaw limitation. Conclusion: The JFLS-20 is an organ-specific instrument comprising 3 constructs for assessing functional status of the masticatory system; the 3 scales exhibit properties that are ideal for both research and patient evaluation in patient groups with a range of functional limitations of the jaw. The JFLS-8 emerged as a short form for measuring global functional limitation of the jaw.

PURPOSE: 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. MATERIALS AND 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.

Objectives: This study evaluated reliability and validity of the Orofacial Aesthetic Scale (OAS)—an instrument assessing self-reported orofacial aesthetics in prosthodontic patients. Methods: The OAS has 7 items addressing direct aesthetical impacts in the orofacial region and an 8th global assessment item. Response format is a 0 to 10 numeric rating scale (”Very dissatisfied” to ”Very satisfied” with appearance). OAS summary scores range from 0 (worst score) to 70 (best score). Test-retest reliability (n=27) and internal consistency (n=119) were assessed. Content validation (asking patients about their satisfaction with the questionnaire content, n=119) and discriminative validation (comparing OAS scores between patients and healthy controls, n=119) were performed. Convergent validity was assessed by correlating patients' own OAS scores (n=29) with ratings from a consensus expert group (n=4) and with the Oral Health Impact Profile (OHIP) aesthetic-item summary score (n=119). Results: Test-retest reliability was excellent for the OAS scores (intraclass correlation coefficient = .96). Internal consistency was satisfactory for aesthetically impaired patients (n=27, Cronbach's alpha=.86). Patients rated their satisfaction with the questionnaire content as 7.8±1.3 units on a 0 to 10 numeric rating scale (0=very dissatisfied, 10=very satisfied). OAS scores discriminated aesthetically impaired patients (31.4 units) from healthy controls (45.9 units, P<0.001). OAS scores correlated well with other measures of the same construct (r=.43 for patients' own assessment with an assessment by experts using OAS, r=-.72 for a correlation with OHIP's 3 aesthetic-related items). Conclusion: The Orofacial Aesthetic Scale, developed especially for prosthodontic patients, exhibited good score reliability and validity.

This study reports the findings and challenges of the assessment of oro-facial aesthetics in the Swedish general population and the development of normative values for the self-reporting Orofacial Esthetic Scale (OES). In a Swedish national sample of 1406 adult subjects (response rate: 47%), OES decile norms were established. The influence of sociodemographics (gender, age, and education), oral health status and general health status on OES scores was analysed. Mean ± standard deviation of OES scores was 50.3 ± 15.6 units (0, worst score; 70, best score); <1% of the subjects had the minimum score of 0, and 11% had the maximum score of 70 OES units. Orofacial Esthetic Scale score differences were (i) substantial (>5 OES units) for subjects with excellent/very good versus good to poor oral or general health status; ii) small (2 units), but statistically significant for gender (P = 0.01) and two age groups (P = 0.02), and (iii) absent for subjects with college versus no college education (P = 0.31) or with and without dentures (P = 0.90). To estimate normative values for a self-reporting health status, instrument is considered an important step in standardisation, and the developed norms provide a frame of reference in the general population to interpret the Orofacial Esthetic Scale scores