Development of the Dentofacial Appearance Perception Scale: Validity and reliability study

Concerns about the appearance of teeth and mouth, which play a key role in communication and first impressions, are natural to some extent. However, excessive concern over these areas should raise suspicion of body dysmorphic disorder (BDD). The use of a validated and standardized screening tool in dental settings may improve the identification of BDD. This study aims to develop a validated tool to alert dentists to potential BDD cases among patients seeking cosmetic dental procedures. The research team conducted a literature review and initially created a pool of 26 items. A qualitative evaluation of the scale items was conducted by the researchers, during which each question was analyzed and discussed, resulting in the reduction of the number of items to 21. During the content validity process, 2 items were removed using the Lawshe technique, and 3 items were excluded during the exploratory factor analysis, finalizing the scale with 16 items. Participants from Izmir Democracy University's Dental Clinic were involved in the study. Both exploratory and confirmatory factor analyses were executed to affirm the scale's construct validity, and reliability was measured through Cronbach alpha. Statistical processing was done using Statistical Package for the Social Sciences and JASP software. After rigorous item analysis and exploratory factor analyses across 2 testing rounds, a finalized version of the questionnaire emerged. A total of 193 individuals voluntarily participated in the study, with 56.67% being female. The participants had an average age of 29.53 years (min: 18, max: 65). Only individuals presenting to the university hospital dental clinic for cosmetic reasons were included in the study. The final version of the scale, comprising 16 items across 3 factors, demonstrated adequate validity and reliability. Factor analysis accounted for 53.72% of the variance, with the factors labeled as follows: "Impairment in Functionality," "Dental Appearance Satisfaction," and "Preoccupation." Confirmatory factor analysis supported the structural integrity of the scale, and overall reliability, as indicated by a Cronbach alpha of 0.90, confirmed its consistency. The Dental Appearance Perception Scale is a reliable and valid tool with the potential to screen for BDD risks and enhance treatment satisfaction in dental settings.