Perceived Smile Esthetics and Psychosocial Impact of Orthodontic Treatment in Individuals with Definite Malocclusion: A Cross-sectional Study

Aim: To assess the perceived smile esthetics and psychosocial impact of orthodontic treatment in individuals with definite malocclusion.Materials and methods: A cross-sectional observational study was conducted on 333 Indian individuals aged 12-40 years with untreated malocclusion of various types.A validated questionnaire based on the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was used, covering eight domains: Self-confidence, social impact, esthetic concerns, psychological impact, speech impairment, functional limitations, matrimonial concerns, and career concerns.Each of the 16 items was scored on a 5-point Likert scale.Data were statistically analyzed using SPSS (Version 30.0), with significance set at p < 0.05.Reliability was assessed using Cronbach's α.Results: The study sample comprised n = 333 Indian individuals between 12 and 40 years of age.The overall questionnaire reliability was acceptable (α = 0.751).Self-confidence concerns showed no gender difference (males: 72, 31.6%;females: 151, 34.5%; p = 0.162).Esthetic concern was higher in males (91, 39.9% with no concern) than in females (243, 55.5%; p = 0.001).Social impact was reported more by males (98, 43.0%) than by females (110, 25.1%; p < 0.001).Matrimonial concerns were greater in males (28, 12.3% severe) compared to females, where most (270, 61.6%) had no concern (p < 0.001).Functional difficulty was more frequent in males (23, 10.1% severe) vs females (18, 4.1%), with 300 females (68.5%) unaffected (p < 0.001).Career, speech, and psychological concerns were also significantly higher among males, while females more often reported no concern across domains. Conclusion:The study demonstrates that individuals with definite malocclusion perceive a substantial psychosocial and esthetic burden even before undergoing orthodontic treatment.Participants commonly reported diminished self-image, lower social confidence, and emotional distress, indicating that malocclusion affects more than just dental function.These perceptions were key motivators for seeking orthodontic intervention, reflecting the strong influence of appearance-and confidence-related concerns, alongside functional needs, on their decision to pursue treatment.Clinical significance: Malocclusion affects not only dental alignment but also mental well-being, self-esteem, and social interactions.This study highlights the importance of assessing psychosocial impacts in untreated individuals to establish meaningful pretreatment benchmarks.Orthodontic care emerges as a transformative intervention that enhances self-image, emotional stability, and overall quality of life.Incorporating patient-reported outcomes into routine assessment allows for more holistic and personalized treatment planning.