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Validity and reliability of the smile perception scale in Turkish children aged 8-10 years
Esra Özgöçmen Tula1, Merve Ayvallı Karagöz2, Merve Alkış3
1Department of Pedodontics, Faculty of Dentistry, Bursa Uludag University, Bursa, Türkiye. esraozgocmentula@uludag.edu.tr.
Introduction:
Dental aesthetics plays a key role in children's social perception and psychosocial development. However, evidence on smile perception in children remains limited, highlighting the need for valid and reliable assessment tools. This study aimed to perform the cross-cultural adaptation and psychometric validation of the Smile Perception Questionnaire for Children Aged 8-10 Years (SPQ 8-10) for use in Turkish children.
Methods:
This observational methodological validity-reliability study included 300 healthy children aged 8-10 years who attended the Department of Pediatric Dentistry at Bursa Uludag University and met the predefined eligibility criteria. Eligible participants were healthy children aged 8-10 years whose parents provided informed consent; children with previous or ongoing orthodontic treatment, systemic diseases, or mental, physical, hearing, or visual impairments affecting communication or questionnaire completion were excluded. The SPQ (8-10) was translated into Turkish using forward-backward translation and expert review. Standardized perioral smile images were digitally generated to represent different dental conditions, and each participant evaluated one randomly assigned image using a five-point Likert scale. Exploratory factor analysis (principal axis factoring) and confirmatory factor analysis (DWLS estimation) were conducted to assess construct validity. Internal consistency (Cronbach's α, McDonald's ω) and test-retest reliability (ICC) were evaluated.
Results:
Cronbach's α coefficient for the scale was 0.844, while McDonald's ω coefficient was 0.847. The analysis yielded ICC (3,1) = 0.803, 95% CI [0.628, 0.901], indicating that the scale had good temporal stability. CFI and TLI values above 0.95 and an SRMR value below 0.06 suggest a good fit. RMSEA value was at the threshold (0.084).
Conclusion:
The final 10-item Turkish version of the SPQ (8-10) demonstrates adequate psychometric properties in terms of factorial structure, internal consistency, and temporal stability.
