PURPOSE: This study evaluated the reliability and validity of the Orofacial Esthetic Scale (OES)-an instrument assessing self-reported orofacial esthetics in prosthodontic patients. MATERIALS AND METHODS: The OES has seven items addressing direct esthetic impacts in the orofacial region, as well as an eighth global assessment item. The response format was a 0 to 10 numeric rating scale (very dissatisfied to very satisfied with appearance, respectively). OES summary scores ranged 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 OES scores between patients and healthy controls, n = 119) were performed. Convergent validity was assessed by correlating patients' own OES scores (n = 29) with ratings from a consensus expert group (n = 4) and with the Oral Health Impact Profile (OHIP) esthetic-item summary score (n = 119). RESULTS: Test-retest reliability was excellent for the OES scores (intraclass correlation coefficient = .96). Internal consistency was satisfactory for esthetically impaired patients (n = 27, Cronbach 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). OES scores discriminated esthetically impaired patients (31.4 units) from healthy controls (45.9 units, P < .001). OES scores correlated well with other measures of the same construct (r = .43 for patients' own assessment with an assessment by experts using the OES, r = -.72 for a correlation with the OHIP's three esthetic-related items). CONCLUSIONS: The OES, developed especially for prosthodontic patients, exhibited good score reliability and validity.