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Validation of the Orofacial Esthetic Scale in the general population

Mike T John1*, Pernilla Larsson2, Krister Nilner3, Dipankar Bandyopadhyay4 and Thomas List5

Author Affiliations

1 Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA

2 Centre of Oral Rehabilitation, Linköping, Sweden

3 Department of Oral Prosthetics, Faculty of Odontology, Malmö University, Malmö, Sweden

4 Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA

5 Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden

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Health and Quality of Life Outcomes 2012, 10:135  doi:10.1186/1477-7525-10-135

Published: 19 November 2012



The Orofacial Esthetic Scale (OES) is an eight-item instrument to assess how patients perceive their dental and facial esthetics. In this cross-sectional study we investigated dimensionality, reliability, and validity of OES scores in the adult general population in Sweden.


In a random sample of the adult Swedish population (response rate: 39%, N=1159 subjects, 58% female, mean age (standard deviation): 49.2 (17.4) years), dimensionality of OES was investigated using factor analytic methods to determine how many scores are needed to characterize the construct. Reliability of scores was calculated using Cronbach’s alpha. Score validity was determined by correlating the OES summary score with a global indicator of orofacial esthetics (OE).


Factor analyses provided support that a single score can sufficiently characterize OE. A Cronbach’s alpha of 0.93 indicated excellent reliability. A validity coefficient of r=0.89 (95% confidence interval: 0.87-0.90) indicated that OES summary scores correlated highly with a global OE assessment.


The OES is a promising instrument to measure the construct OE. Factor analyses supported that this construct can be assessed with one score, offering a feasible and acceptable standardized assessment of OE. The present study extends the OES use to the general population, an important target population for assessment of orofacial esthetics.