Social Appearance Anxiety Among a Sample of Turkish Adolescents and Young Adults With Cleft Palate With or Without Cleft Lip: A Cross-Sectional Controlled Study

Achoimre

Objective To compare social appearance anxiety between Turkish adolescents and young adults (AYAs) with cleft palate with or without cleft lip (CP ± L) and a comparison group without CP ± L. Design Cross-sectional study. Setting Orthodontic clinic in a university dental hospital. Participants AYAs 10 to 29 years old (N = 151; 70 with CP ± L and 81 without CP ± L; mean age 16.62 ± 6.66 years; 50.3% female and 49.7% male). Main Outcome Measure The validated Turkish Social Appearance Anxiety Scale (SAAS) was completed, with group comparisons using Welch's t-test and multiple linear regression including cleft status, age, sex, and family history of cleft. Results AYAs with CP ± L had a significantly higher mean SAAS score of 51.43 ± 14.18, compared with 35.58 ± 12.35 in AYAs without CP ± L (95% CI, 11.54–20.16; p < 0.001), corresponding to a large effect size (Hedges’ g = 1.19; 95% CI, 0.85–1.60). After adjustment for age, sex, and family history of cleft, CP ± L status remained associated with higher SAAS scores (B = 13.45; 95% CI, 8.66–18.24; standardized β = 0.437; p < 0.001). No statistically significant associations were found for age, sex, or family history of CP ± L. Conclusion Turkish AYAs with CP ± L reported substantially higher social appearance anxiety than those without CP ± L. CP ± L status remained independently associated with higher SAAS scores after adjustment for age, sex, and family history. The results suggest that appearance-related social concerns deserve attention as part of the broader psychosocial care of AYAs with CP ± L.