Aim: The study aimed to develop an instrument for assessment of perception of orofacial appearance and psychological issues that can affect patients’ judgments. Materials and methods: A panel composed of five members (psychologist, two prosthodontists, orthodontist, and finalyear dental student) generated 31 items that could draw specific hypothetical dimensions. The questionnaire was selfadministrated by the Caucasians attending local high school and university (N=261 ; 26.4% male) in the 14–28 age range. Internal consistency, construct validity, responsiveness and temporal stability were assessed. Results: Factorial analysis and Cronbach’s alpha identified four dimensions (self- esteem, perfectionism, body image and smile appearance concern) that can be best fitted by 17 items. Internal consistency was good (α in 0.70– 0.80 range). The dimensions correlated with the existing instruments that measure similar constructs. In responsiveness testing, tooth whitening did not induce changes in perfectionism and body image, however it increased self-esteem and decreased aesthetic concern (p
