AODTII: Adolescent Oro-Dental Trauma Impact Index- Developed and Validated in Sri Lanka

Abstract Background Sports-related oro- dental trauma, such as tooth fracture, displacement, mobility, and avulsion, cause significant concern among adolescent players due to detrimental impacts. This study aimed to develop and evaluate the validity and reliability of a simple index as a questionnaire to assess the impact of oro-dental trauma on adolescents. Methods AODTII, an adolescent oro-dental trauma impact index was developed and validated using a mixed-method approach. Items used to generate the index were defined based on the qualitative and quantitative analysis of the results from Oral Health-Related Quality of Life Questionnaires, personnel interviews with experts and focus group discussions with adolescents. Principal component analysis and Exploratory factor analysis were used to create the index. The validity and reliability of the developed index were assessed using a separate sample. Results The initial list of 28 items was reduced to 12 by the Principal Component Analysis. Exploratory Factor Analysis categorised the variables into four latent constructs; physical impact, psychosocial effect influenced by peer pressure, the impact of oral health care and the impact caused due to unmet dental trauma treatment need. The cut-off values of the AODTII were based on PCA. The index achieved the Content Validity Ratio of 88.33. The construct validity was assessed with confirmatory factor analysis by developing a structural equation model. It obtained good model fit indices of RMSEA value of 0.067, SRMR of 0.076, CFI of 0.911 and the Goodness of Fit index of 0.95. The homogeneity was ensured with convergent and discriminant validity. The Cronbach's alpha value was 0.768, ensuring reliability. The index assesses the level of impact due to oro- dental trauma and identifies whether the adolescents perceive it significantly or not. Conclusion AODTII can be used as a valid and reliable index to assess the impact of oro- dental trauma on adolescents. It can be used as a clinical adjunct, an advocacy tool and a useful OHRQoL instrument.