Introduction

Perceived dental neglect (PDN) is an important but underexplored construct among adolescents, particularly in low and middle-income settings. This report is on the development and validation of a novel scale to determine the PDN among 15-19-year-old Sri Lankan adolescents.

Methods

An initial pool of 55 items was generated from literature (n=35) and qualitative inputs, including focus group discussions and key informant interviews (n=20). Following expert review, items were reduced to 30 and further refined to 18 using the content validity index. The 18-item scale was translated, pretested, and subjected to statistical item selection procedures. Scale refinement and validation were conducted using Principal Axis Factoring (PAF) and Rasch analysis on data collected from 304 Sri Lankan adolescents.

Results

The 18-item scale was reduced to 11 items following PAF and Rasch analysis. PAF identified three factors, beliefs, attitudes, and dental apathy, explaining 60% of the variance. Internal consistency was acceptable (Cronbach’s α was 0.735; mean inter-item correlation was 0.206). Rasch analysis showed no local dependency (r < 0.3), and model fit was not improved by item removal; minor threshold disorders were resolved through rescoring.

Conclusions

The PDN-11 demonstrated sound psychometric properties, with a three-factor structure (beliefs, attitudes, and dental apathy) supported by factor and Rasch analyses. With acceptable internal consistency and satisfactory model fit, it is a reliable and valid tool for assessing perceived dental neglect among adolescents. Given the increased vulnerability to dental caries and the initiation of risk behaviours during adolescence, this tool is valuable for early identification of at-risk individuals and supports timely preventive and primordial interventions.

Keywords: Perceived dental neglect, Factor analysis, Rasch analysis, Adolescents, Oral health