Cross-cultural adaptation and psychometric properties of the child perceptions questionnaire 11-14 (CPQ11-14) for the peruvian spanish language

Objectives: Oral-Health-Related Quality of Life (OHRQoL) instruments, such as the Child Perceptions Questionnaire 11-14 (CPQ11-14), are broadly used in oral health surveys around the world. However, there is a lack of these instruments in Spanish language limiting the comparison of OHRQoL outcomes among countries, cultures and ethnic groups. The aim of the present study was to cross-culturally adapt the CPQ11-14 to the Peruvian Spanish language and assess its reliability and validity. Material and Methods: To test the translation and cross-cultural adaptation, 60 children aged 11-to-14-years answered the CPQ11-14 in two pilot tests. After that, the questionnaire was tested on 200 children of the same age, who were clinically examined for dental caries. The internal consistency was assessed by Cronbach’s alpha coefficient while repeat administration of the CPQ11-14 on the same 200 children facilitated the test-retest reliability via intraclass correlation coefficient (ICC). Construct and discriminant validity were based on associations of the CPQ11-14 with global ratings of oral health and clinical groups respectively. Results: The mean (standard deviation) CPQ11-14 score was 20.18(13.07). Internal consistency was confirmed by a Cronbach’s alpha of 0.81. Test-retest reliability revealed excellent reproducibility (ICC= 0.92). Construct validity was confirmed demonstrating statistically significant associations between total CPQ11-14 score and global ratings of oral health (p=0.035) and overall well-being (p<0.001). The measure was also able to discriminate between children with dental caries experience and those without (mean scores: 26.32 and 12.96 respectively; p<0.001). Conclusions: The Spanish CPQ11-14 has satisfactory psychometric properties and is applicable to children in Peru. Key words:Oral health, quality of life, children, adolescent, validity, reliability.     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

Health-related quality of life of children aged 11 to 14 years with orofacial conditions.

OBJECTIVE: To assess the health-related quality of life (HRQoL) of 11- to 14-year-old children with orofacial conditions. DESIGN: Thirty-nine patients with orofacial conditions were compared with 32 patients with dental caries. OUTCOME MEASURE: The multidimensional 37-item Child Perceptions Questionnaire for 11- to 14-year-old children (CPQ(11-14)). This forms one component of the Child Oral Health Quality of Life Questionnaire. RESULTS: The orofacial group had slightly higher scores on the CPQ(11-14) than the dental group (p < .05). The scores were slightly to moderately higher on the functional limitations (p < .01) and social well-being (p < .01) domains. The groups did not differ with respect to oral symptoms or emotional well-being. Mouth breathing, problems with speech, missing school, being teased, and being asked questions about their condition were the only issues reported more frequently by the orofacial group (p < .01). There was no evidence of social inhibition or withdrawal in the orofacial group. The children with orofacial conditions rated their oral health better than the children with dental decay (p < .05). In both groups, the majority of children reported that their condition had little impact on their life overall. CONCLUSIONS: Based on CPQ(11-14) scores, there were few differences in the HRQoL of 11- to 14-year-old children with orofacial conditions, compared with children with dental caries. This suggests that the majority of these children are well adjusted and able to cope with the adversities they experience as a result of their conditions. This may reflect the quality of the team approach used at the treatment setting at which they were recruited.     

An evaluation of the Child Perceptions Questionnaire in the UK

OBJECTIVE: To assess the reliability and validity of the Child Perceptions Questionnaire (CPQ11-14), an oral health related quality of life measure for 11-14 year old children, for use in the UK. BASIC RESEARCH DESIGN: Cross-sectional questionnaire and clinical analytical study. CLINICAL SETTING: Orthodontic and paediatric dentistry clinics at a dental hospital and one general dental practice. PARTICIPANTS: Eighty-nine children between 11 and 14 years of age attending for an examination. MAIN OUTCOMES MEASURES: The children were invited to complete the CPQ11-14, global oral health and impact on life overall ratings. Clinical data on caries status, malocclusion and presence of dental opacities and gingivitis were collected. CPQ11-14 was summarised as the total score (sum of the item codes) and the number of impacts reported often or every day. RESULTS: The Cronbach's alpha for the total scale was 0.87 and ranged from 0.59 to 0.83 for the subscales indicating acceptable internal consistency. The intraclass correlation coefficient on repeated application of the measure was 0.83 (95% CI = 0.76-0.90) suggesting almost perfect agreement. Summary measures of CPQ11-14 correlated with the global oral health rating indicating acceptable criterion validity. Impact on life overall was related to all summary measures of CPQ11-14. Number of impacts correlated with the total number of missing teeth and missing teeth due to caries. No other relationships between clinical and CPQ11-14 data were apparent. CONCLUSION: The CPQ11-14 shows acceptable reliability, criterion and construct validity in relation to life overall. Relationships with clinical data were more tenuous. If this measure is to be used to compare the impacts of oral diseases in similar settings in the UK a large sample will be required.     

Evaluation of a quality of life measure for children with malocclusion

OBJECTIVE: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion. DESIGN: A cross-sectional study comparing two groups of individuals. SETTING: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield. SUBJECTS AND METHODS: The malocclusion group consisted of 116 patients aged 11-14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11-14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT 相似文献   

Subjective impacts of dental caries and fluorosis in rural Ugandan children

OBJECTIVE: Describe the oral health related quality of life among a group of children in rural Uganda and compare impacts on oral health related quality of life associated with dental caries and fluorosis. BASIC RESEARCH DESIGN: Cross-sectional clinical and questionnaire analytical study. PARTICIPANTS: Proportional sample of 174 12 year olds attending primary schools in a rural sub-county of Uganda. OUTCOME MEASURES: Clinical assessments using WHO basic methods and the Thylstrup and Fejerskov index of Fluorosis (TFI). Child Oral Health Related Quality of Life data collected with self-administered child perception questionnaire (CPQ11-14). RESULTS: Two thirds of children reported a dental impact 'often' or 'everyday'. The mean number of impacts per child at this threshold was 2.6 and the mean total CPQ11-14 score was 25.8 (sd 21.1). Mean DMFT was 0.68. No children had fillings. Forty-one children had dental fluorosis with 10 having scores greater than 2. CPQ11-14 showed acceptable criterion validity and reliability. The number of sites with gingivitis or the presence of calculus or trauma were not associated with summary measures of CPQ11-14 whereas having any dental caries or treatment experience was associated with higher total scores and more impacts. Socially noticeable fluorosis (TFI >2) was associated with more impacts but not with higher total scores. CONCLUSIONS: Despite low levels of oral disease these children experience appreciable impacts on oral health related quality of life. The greatest burden was associated with dental caries and to a lesser extent, fluorosis.     

What do children's global ratings of oral health and well‐being measure?

OBJECTIVES: To explore the constructs children incorporate in the responses to global ratings of their oral health (OH) and OH-related overall well-being (OWB). METHODS: Data were collected as part of a project to validate the Child Perceptions Questionnaire for ages 11-14 (CPQ11-14), a self-report measure of OH-related quality of life. Its 37 questions are organized in the symptoms, functional limitations, emotional and social well-being domains. Children were recruited from paediatric dentistry, orthodontic and orofacial dental clinics. To identify the CPQ11-14 domain scores and questions predicting the global ratings, correlation and multiple regression analyses were used. RESULTS: Of the 123 children, 22.8% rated their OH as 'Fair/Poor' and 30.1% reported that their OWB was affected by their oral/orofacial condition. Positive significant correlations were observed between the OH ratings and the CPQ11-14 oral symptoms and emotional well-being domains, and between the OWB ratings and all four CPQ11-14 domains. The number of the CPQ11-14 questions significantly correlated with the OH and OWB ratings were 8 and 19, respectively. Only the symptoms domain entered the model for the OH (R2=0.05), while age, functional limitations and emotional well-being domains predicted the OWB (R2=0.18). The OH model included three questions (R2=0.13) and the OWB model included age and six questions (R2=0.25). In both models all but one of the questions came from the emotional and social well-being domains. CONCLUSIONS: These findings suggest that children view OH and its impact on well-being as multidimensional concepts. Further research, including qualitative studies, is needed to better understand the referents children use when responding to global ratings and the factors that determine their responses.     

The German version of the Child Perceptions Questionnaire (CPQ-G11-14): translation process, reliability, and validity in the general population

The aims of this study were to develop a German version of the Child Perceptions Questionnaire (CPQ11-14, a measure of oral health-related quality of life in 11–14-year-old children) and to assess the instrument’s reliability and validity in German children ages 11–14. The English original version of the CPQ11-14 questionnaire was translated into German (CPQ-G11-14) by a forward–backward translation method. Reliability was investigated in 1,061 subjects aged 11–14 years from a regional sample (Wernigerode, Saxonia-Anhalt, Germany) who were recruited during the annual dental public health examination. The subjects completed the CPQ-G11-14 and were clinically examined for the presence of dental caries, plaque accumulation, and malocclusion. In the reliability assessment, questionnaire summary score test–retest reliability was excellent (intraclass correlation coefficient, 95% confidence interval (CI) = 0.83, 0.73–0.94) and internal consistency was satisfactory (Cronbach’s alpha, lower limit of CI = 0.87, 0.86). Validity of the CPQ-G11-14 questionnaire was supported by correlations with global ratings of oral health and overall well-being that were moderate in magnitude and met expectations (r = 0.35; 95% CI, 0.30–0.40 and r = 0.30; 95% CI, 0.24–0.35, respectively). In conclusion, the German version of the CPQ11-14 was reliable and valid in a general population of 11–14-year-old German children.     

中文版儿童感知问卷的信度检验

目的：建立儿童感知问卷（Child Perceptional Questionnaire-CPQ）中文版,并分析其信度、效度。方法：按量表翻译程序将问卷翻译成中文,在寻求正畸治疗的患者中选择541名11~14岁的儿童,要求其完成CPQ11-14问卷。随机选择54名患者2周后重填问卷。结果：Cronbach＇sα系数在0.68-0.89间,重测信度ICC值在0.64~0.88间。自我认为需要接受正畸治疗CPQ11-14分数显著高于认为自己不需要接受正畸治疗的个体;认为牙齿对生活质量没有影响的个体的CPQ11-14均数也显著低于认为对生活有影响的个体。结论：中文版的CPQ11-14问卷具有较好的效度和信度,能用于研究儿童与口腔健康相关的生活质量。     

Developmental enamel defects and their impact on child oral health-related quality of life

This cross-sectional study assessed the impact of Developmental Enamel Defects (DED) on Child Oral Health-Related Quality of Life (COHRQoL). A sample of 944 11- to 14-year-old Brazilian schoolchildren was examined for the prevalence and severity of DED. The children completed the Child Perceptions Questionnaire (CPQ11-14), and socioeconomic status was also collected using a questionnaire. Poisson regression models were used to assess the association between DED and overall and domain-specific CPQ11-14 scores. The prevalence of DED was 19.7%. In general, children with DED did not indicate any decrease in self-perception. However, this condition was associated with an impact on the functional limitation domain. The presence of DED may cause negative impacts on a child's perception of oral health and on their daily performance.     

Is the Child Perceptions Questionnaire for 11–14 year olds sensitive to clinical and self‐perceived variations in orthodontic status?

OBJECTIVES: To assess the association between scores on the Child Perceptions Questionnaire for 11-14 year olds (CPQ11-14) and clinical and self-perceived measures of malocclusion. METHODS: Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the CPQ11-14 and a short questionnaire concerning their feelings about the condition of their teeth. Study models were taken and rated according to the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index by two sets of three examiners. Intra and inter-rater reliabilities for the two sets of examiners ranged from 0.80 to 0.99. CPQ11-14 scores were calculated for the full 35-item version and for 16 and 8-item short forms by summing the item response codes. The association between these scores, the DAI and PAR ratings and self-perceived measures of malocclusion were examined using appropriate parametric and nonparametric tests. RESULTS: Complete data were collected for 141 children, 63 boys and 78 girls. The mean age was 12.5 (SD = 1.0). DAI scores ranged from 17.0 to 58.0 with a mean of 35.0 (SD = 8.0). The distribution of subjects across the four severity categories was minor/none - 6.6%, definite - 35.2%, severe - 15.6% and handicapping 42.6%. PAR scores ranged from 8.0 to 66.0 with a mean of 31.4 (SD = 11.1). Eight percent had scores of 50 or above indicating marked deviation from an ideal occlusion. Both the long and the short forms of the CPQ11-14 identified substantial variability in the impacts of malocclusion. Correlations between CPQ11-14 scores and the orthodontic indices ranged from 0.26 to 0.31 (P < 0.01). There was a clear gradient in CPQ11-14 scores across four categories of the PAR based on quartiles. The gradient across the DAI categories was less clear. There were significant associations between all CPQ11-14 scores and the children's self-ratings of oral health, ratings of the extent to which the condition of the teeth affected life overall and expressions of happiness with the appearance and arrangement of the teeth. CONCLUSION: The results provide some evidence of the validity of the CPQ11-14 when used with children needing orthodontic treatment. However, because clinical samples are biased the study needs to be repeated in different treatment settings in order to confirm the utility of the measure.     

乌鲁木齐市11～14岁儿童口腔健康相关生活质量的测定

目的 建立11~14岁儿童口腔健康问卷(The Child Perceptions Questionnair11~14,CPQ11~14)的中文版,测定其信度、效度等心理测量学特性,为其在中国适龄儿童中的推广使用提供理论依据。方法 通过对CPQ11~14英文版的翻译、回译、文化调适,制定出CPQ11~14的中文版。采用整群分层抽样方法随机抽取乌鲁木齐市11~14岁在校学生377人,对其进行中文版CPQ11~14问卷的调查,同时作口腔检查。结果 量表平均得分为8.93±5.65,口腔症状分项得分最高,社交分项得分最低。该量表的Cronbach′sα系数为0.75,所有条目删除后,Cronbach′sα系数均不增加。重测信度系数为0.75。因子分析法显示量表具有较好的结构效度。CPQ11~14得分与口腔健康状况及DMFT之间有明显相关性,提示该量表具有良好的区分效度。结论 本研究显示CPQ11~14中文版具有良好的信度与效度,中文版适用于乌鲁木齐市11~14岁儿童。     

Validity of single-item parental ratings of child oral health

Objective. The aim of this study was to assess the validity of single-item parental ratings of child oral heath. Methods. Data were collected during a study to assess the impacts of dental injury. Clinical examinations of children aged 11–14 years were undertaken that included measures of trauma, decay, treatment needs, and fluorosis. Children with trauma and a group of trauma-free children were followed-up. Parents were mailed a questionnaire along with a questionnaire for the child that contained a short form of the Child Perceptions Questionnaire 11–14 (CPQ11–14). Bivariate analyses examined associations between parents’ ratings of their child's oral health, measures of dental disease, clinically defined treatment needs, and scores on the CPQ11–14. Logistic regression was used to see if the associations observed remained after controlling for access to dental care variables. Results. Complete data were collected from 370 children and their parents. Parental ratings showed significant associations with most of the clinical indicators used and CPQ11–14 scores. Similar results were obtained when the data were analysed for subgroups defined by household income and mother's education. These associations remained after controlling for access to dental services. Conclusion. The data suggest that single-item parental ratings of child oral health have adequate construct validity.     

Association of Gingivitis With Child Oral Health–Related Quality of Life

Background: Child oral health–related quality of life (COHRQoL) has been increasingly assessed. However, the full relationship between gingivitis and COHRQoL has been assessed by only a small number of studies. This study aims to assess the association between gingival bleeding and how a child perceives its OHRQoL. Methods: This cross‐sectional study used multistage random sampling to enroll 1,134 12‐year‐old schoolchildren from Santa Maria, a southern city in Brazil. Participants were examined for gingival bleeding according to the community periodontal index criteria, a full‐mouth clinical examination of six sites per tooth. COHRQoL was assessed by the Brazilian version of the Child Perceptions Questionnaire for 11‐ to 14‐Year‐Old Children (CPQ11–14), and data on socioeconomic status were collected. Multilevel Poisson regression models fitted the association of gingivitis with overall and domain‐specific CPQ11–14 scores. Results: In general, children with bleeding in ≥15% of sites had higher total CPQ11–14 scores and domain‐specific scores than their counterparts. This association persisted after adjustment for other potential confounders. The presence and extent of gingival bleeding was associated mainly with emotional limitation domains of the CPQ11–14; those with extended levels of gingivitis had a 1.20 times higher mean score than those with low‐level/no gingival bleeding (rate ratio = 1.20; 95% confidence interval = 1.10 to 1.31). Conclusion: The present results indicate that the presence of extensive levels of gingivitis might be negatively associated with how children perceive their oral health and their daily life.     

Back Matter

Abstract

Objective: To explore the validity and reliability of the child perception questionnaire as an oral-health-related quality of life (OHRQoL) measure in adolescents with malocclusion.

Design: A cross-sectional study comparing two groups of individuals.

Setting: One group of children with malocclusion was recruited from the orthodontic departments at the Charles Clifford Dental Hospital (CCDH), Sheffield and Chesterfield Royal Hospital (CRH), Chesterfield. A second group with no malocclusion was recruited from the Paediatric Department at CCDH and one General Dental Practice in Sheffield.

Subjects and methods: The malocclusion group consisted of 116 patients aged 11–14 years about to commence orthodontic treatment. The non-malocclusion group consisted of 31 11–14-year-old patients with index of orthodontic treatment need (IOTN) 1 and 2, and DMFT ≤2, with no history of orthodontic treatment. The children completed the child perception questionnaire (CPQ), including global ratings of oral health and satisfaction. Each child rated their own IOTN aesthetic component (AC) score.

Outcome measures: Total CPQ scores and responses in the four domains. Self-perceived AC scores and responses to global rating of oral health, life overall and satisfaction rating were recorded.

Results: There was a statistically significant difference between the malocclusion and non-malocclusion total CPQ scores (P = 0.012). These differences were significant for the emotional (P = 0.006) and social well-being (P = 0.001) health domains, and not significant for the oral symptoms and functional limitations health domains. There were significant correlations between the total CPQ score and overall well-being (R _s = 0.397) and patient satisfaction (R _s = 0.362).

Conclusions: Malocclusion has a negative impact on the OHRQoL of an adolescent. A shortened version of this form, specifically for prospective orthodontic patients, may be beneficial as an additional measure to assess need for treatment especially as some of the questions in the oral symptoms and functional limitations subscales of the current questionnaire are not relevant to orthodontic patients.     

Validity and reliability of the Arabic translation of the child oral-health-related quality of life questionnaire (CPQ11-14) in Saudi Arabia

AIM: The purpose of this study was to test the validity and reliability of an Arabic translation and adaptation of the child oral-health-related quality of life questionnaire (CPQ(11-14)) in Saudi Arabia. DESIGN: The modified questionnaire included two global ratings (oral health and oral-health-related well-being), and a battery of 36 questions in four domains (oral symptoms, functional limitations, emotional well-being and social well-being). The study population consisted of 174, 11-14-year-old children (65% healthy and 35% medically compromised). Clinical data on caries status and malocclusion were collected for 138 of the children, and 47 completed the questionnaire a second time. RESULTS: There was a significant difference in mean total scale scores between children with and without malocclusions (P < 0.05). Significant relationships were identified between caries status and oral symptoms subscale scores, and between malocclusion and total scale and social well-being subscale scores (P < 0.05). Correlation was highly significant between scale scores and global ratings (P < 0.01). Cronbach's alpha was 0.81 and the test-retest reliability was substantial (r = 0.65, P < 0.001). However, problems were encountered in Saudi Arabia regarding self-reporting of age, and the questionnaire was too long for many of the medically compromised patients. CONCLUSIONS: The questionnaire is valid and reliable for use in Saudi Arabia, although development of a shorter version is recommended.     

Disparities in oral health-related quality of life in a population of Canadian children

OBJECTIVES: To assess socioeconomic disparities in the oral health-related quality of life in a group of Canadian children. METHODS: Data were obtained as part of a study designed to assess the functional and psychosocial impact of traumatic dental injury. Clinical data were collected on a random sample of children during a school-based dental screening program that included measures of dental decay experience, treatment needs, dental trauma, fluorosis, and malocclusion. Children with dental trauma and a comparison group of trauma-free children were selected for follow-up. Their parents were mailed a questionnaire concerning the child's personal and family characteristics. Also enclosed was a questionnaire for the child that contained a short form of the Child Perceptions Questionnaire (CPQ) 11-14. Bivariate and multivariate analyses were undertaken to determine whether there were disparities in oral health-related quality of life according to household income. RESULTS: Complete data were collected from 370 children. Mean CPQ11-14 scores showed a gradient across income categories with children from low income households having poorer oral health-related quality of life. Children from households containing only one adult also had higher scores than children living with two or more adults. In both linear and logistic regression analyses household income and family structure remained significant predictors of CPQ11-14 scores after controlling for oral disease variables. Further analyses suggested that oral disorders had little impact on the health-related quality of life of higher income children but a marked impact on lower income children. The highest mean CPQ11-14 scores were observed among low income children with the more severe levels of oral disease. CONCLUSION: The data indicate that in this group of children there were socioeconomic disparities in oral health-related quality of life. A potential explanation may be differences in psychological assets and psychosocial resources.     

Validation of the Child Perceptions Questionnaire (CPQ 11-14)

While the use of adult oral-health-related quality-of-life (OHRQoL) measures in supplementing clinical indicators has increased, that for children has lagged behind, because of the difficulties of developing and validating such measures for children. This study examined the construct validity of the Child Perceptions Questionnaire (CPQ(11-14)) in a random sample of 12- and 13-year-old New Zealanders. It was hypothesized that children with more severe malocclusions or greater caries experience would have higher overall (and subscale domain) CPQ(11-14) scores. Children (N = 430) completed the CPQ(11-14) and were examined for malocclusion (Dental Aesthetic Index) and dental caries. There was a distinct gradient in mean CPQ(11-14) scores by malocclusion severity, but there were differences across the four subscales. Children in the worst 25% of the DMFS distribution had higher CPQ(11-14) scores overall and for each of the 4 subscales. The construct validity of the CPQ(11-14) appears to be acceptable.     

Questionnaire for measuring oral health-related quality of life in eight- to ten-year-old children

PURPOSE: This study measured oral health-related quality of life for children, which involved the construction of child perceptions questionnaires (CPQs) for ages 6 to 7, 8 to 10, and 11 to 14. The purpose of this study was to present the development and evaluation of the CPQ for 8- to 10-year-olds (CPQ8-10). METHODS: Questions (N=25) were selected from the CPQ for 11- to 14-year-olds based on the child development literature and input from parents, child psychologist, and teacher of grades 3 and 4. Validity and reliability were evaluated on 68 and 33 children, respectively. RESULTS: There was a positive moderate correlation between the CPQ8-10 score and overall well-being rating (R=.45). The level of impact was slightly higher in the orofacial than in the pediatric dentistry group (mean score=19.1 vs 18.4, respectively). Hypotheses concerning the relationship between the CPQ8-10 score and number of decayed surfaces were confirmed with R=.29, and the mean score higher in caries-afflicted than caries-free children (21.1 vs 14.7). The Cronbach's alpha and intraclass correlation coefficients were 0.89 and 0.75, respectively. CONCLUSIONS: Results suggest good construct validity, internal consistency, reliability and test-retest reliability, but do not demonstrate discriminative validity. This is consistent, however, with theoretical models of oral disease and its consequences. Further research is required, as these are preliminary findings based on convenience sampling.