Self-perception Of Malocclusion Research Articles

Social Impact and Self-Perception of Malocclusion among Adolescents in a Tertiary Centre of Eastern Nepal

Introduction: Malocclusion, defined as an improper relationship between teeth in the opposite jaws, has been a prevalent disorder in recent decades. There has been an increased concern about dental appearance during childhood and early adulthood. Objective: To assess the social impact and self-perception of malocclusion among adolescents and to investigate whether the types and severity of malocclusion have any effect on adolescents’ social acceptance. Methods: A total of 301 participants were chosen from middle and high school with ages ranging from 12 to 19 years. After completion of the questionnaire to assess social impact, all the participants were examined using the Index of Orthodontic Treatment Need (IOTN). Results: Malocclusion severity has a negative correlation with satisfaction with dental appearance (σ: -0.385; p-value: <0.001). Similarly, the severity of malocclusion has weak positive correlation with treatment needs (σ: 0.156; p-value: 0.007) and social impact (σ: 0.171; p-value: 0.003). Conclusions: Different subjective domains of social impact and self-perception are influenced by the severity of malocclusion among adolescents visiting tertiary care center in Eastern Nepal.

Assessment of self-perceived malocclusion and barriers to orthodontic treatment: A cross-sectional study.

Malocclusion is a common dental issue that can lead to significant oral health problems. However, patient management and treatment options for malocclusion can vary, and there is a lack of information regarding self-perception and barriers to orthodontic care. This study aimed to assess the self-perception of malocclusion and explore barriers to orthodontic care among residents of Bandar Saujana Putra in Klang Valley, Malaysia. A cross-sectional study through the use of a validated questionnaire was distributed to the residents of Bandar Saujana Putra. Responses were collected from June 2021 to February 2022 via both online (Google Forms) and physical forms. The questionnaire consists of four sections, which assessed the respondents' demographics, understanding and awareness toward malocclusion, and barriers to orthodontic care. Responses were analyzed using the Pearson Chi-square test with IBM SPSS version 26. A total of 231 responses were collected from 83 (35.9%) males and 148 (64.1%) females. Females had a significantly higher level of awareness and knowledge regarding malocclusion compared to males (P < 0.05). The majority of the female respondents (83.8%) agreed that malocclusion can lead to dental caries (P = 0.02) and 60.8% of them identified "unpleasant appearance" as the main barrier to orthodontic treatment (P < 0.001). The findings suggest that clear braces could be a viable alternative for patients who are concerned with their appearance and may be a solution to the barrier of "unpleasant appearance." Our study contributes to the existing literature on malocclusion and barriers to orthodontic care in Malaysia.

Factors Influencing Appliance Wearing Time during Orthodontic Treatments: A Literature Review

This review aims to analyze the multiple factors affecting patients’ level of compliance (how much they wear removable devices/clear aligners) during orthodontic treatments and to investigate the available methods and devices to monitor the appliance wearing time and to improve it. A literature search was conducted on electronic databases (Pubmed, Scopus, and Google Scholar). The results of the present study suggest that compliance indicators may misestimate the intraoral wearing time. Compliance is affected by patient-related factors (age, personality traits, the importance of personal appearance, self-perception of malocclusion), appliance-related factors (visibility, pain/discomfort), and clinician-related factors (trust, clear and complete communication, motivation). The motivation of pre-pubertal patients is mostly external, while adolescents/young adults have intrinsic motivation for orthodontic treatment. Patients’ self-reports tend to overestimate the appliance wearing time. Even if there is a lack of evidence, teledentistry might improve patients’ awareness of being monitored, thus increasing the time for which orthodontic devices are worn. Compliance is a key factor for clear aligner treatments, but high-quality studies focusing on this aspect are missing. Further studies should focus on how to handle the lack of cooperation and how to increase compliance in order to maximize the treatment’s results.

The Psychosocial Impact of Dental Esthetics in Undergraduates with Borderline Malocclusion.

Background The study investigates the existing correlation between self-perceived malocclusion, the psychosocial impact of dental esthetics, and whether this link involves personality traits. Methods The 179 questionnaires from 615 undergraduates in Wenzhou were used for analysis after applying the exclusion criteria. The Psychosocial Impact of the Dental Aesthetics Questionnaire (PIDAQ) was administered to evaluate participants' perceptions of the psychosocial impacts of malocclusion. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). The Chinese version of the Eysenck Personality Questionnaire-Short Scale (EPQ-RSC) evaluated participants' personality characteristics. The Kruskal-Wallis test was used to assess differences between the IOTN-Dental Health Component (DHC) and expectations of orthodontic treatment. Linear regression was applied with PADAQ and its subscale scores against possible variables. Results The total and subscale PIDAQ scores were positively correlated with neuroticism. Total PIDAQ scores, the DHC, and the Aesthetic Component (AC) were significantly positively correlated with the subjective AC. The DHC was significantly negatively correlated with extroversion. Conclusions We confirmed a modest link between the need for orthodontic treatment and the psychosocial impact of dental esthetics.

RETRACTED ARTICLE: Self-perception of malocclusion among Saudi adolescents using the aesthetic component of the IOTN

This study was carried out to assess the self-perception of dental appearance among Saudi adolescents in Qassim province using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) to compare it with an orthodontist’s rating and whether the age and gender had any influence on it. A sample of 600 randomly selected school adolescents comprising 297 (49.5%) males and 303 (50.5%) females with age range of 12–17 years old were included in the study. The AC of the IOTN, was the instrument used to measure the perception of malocclusion by both the school adolescents and the orthodontist. t test and Chi-square statistics were used to analyze the data with statistical significance set at P < 0.05. Majority of the students (86.7%) scored themselves as having an attractive dentition with no need of orthodontic treatment. There was a significant difference between the orthodontists' rating and the students' rating (P < 0.05). Further, the gender was not found to be statistically significant in relation to the self-perception of treatment need (P = 0.123), while the age was found to be statistically significant (P < 0.001). A significant difference was found between the orthodontists' rating and the students' ratings of the attractiveness of their occlusions. The age was found to influence the self-perception of orthodontic treatment need, whereas the gender was not found to have any influence. Therefore, for effective orthodontic treatment plan, the self-perception of dental appearance must be taken into consideration to ensure patient satisfaction.

Clinical parameters associated with obesity outcomes in vulnerable adolescents

Objective: Overweight and obesity rates are growing at alarming levels worldwide. Adolescents of higher socioeconomic status are more likely to be overweight, however, information from economically vulnerable populations is lacking. Therefore, the present study aimed to determine the impact of normative and self-perceived clinical aspects on the outcomes of obesity in vulnerable adolescents. Methodology: Observational cross-sectional study with 239 adolescents with an average age of 13 years, enrolled in public schools in Sabará (Minas Gerais). Body Mass Index values were obtained and classified according to AnthroPlus software. Dental Health Component of the Index of Orthodontic Treatment Need (IOTN) evaluated the normative malocclusion and the Aesthetic Component of IOTN the subjective occlusal evaluation. DMFT index evaluated dental caries activity and experience. Crude Odds Ratio values were estimated and adjusted, with a 95% confidence interval and a 5% significance level. Results: Adolescents with self-perceived malocclusion were less likely to be obese (P &lt;0.05). Overall, 20.0% of the adolescents with self-perceived malocclusion were obese as compared to 40.6% of those with no self-perceived malocclusion. Obesity was not found to be associated with the variables of sex and dental caries (P &gt;0.05). Conclusion: Adolescents with self-perceived malocclusion were less likely to be obese, suggesting that obesity is associated with perceived malocclusion, but not with caries experience.

Impacts of Self Perceived Malocclusion on the Oral Health Related Quality of Life of Young Adults.

Self-awareness of poorly arranged teeth can influence the quality of life. This study aimed to report the impacts of self-perceived malocclusion in young adults and the association between demographic characteristics and oral health related quality of life (OHRQoL). In this cross-sectional study, six-hundred-forty-three subjects from Selangor, Malaysia selected using a multistage sampling technique answered the Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and self-rated their dental appearance using the Aesthetic Component of the Index of Orthodontic Treatment Need. Data were analyzed using multifactorial ANOVA to identify the association between demographic characteristics and total PIDA score. Five-hundred-twenty-four subjects (81.5%) completed the questionnaires. Overall, 87.8% had impacts on their OHRQoL. Psychological impact was the most impacted domain (75.8%), followed by dental self-confidence (59.4%), social impact (48.9%) and aesthetic concern (22.1%). 16.8% reported significant impacts on all domains. Their mean PIDA score was 36.3 (SD 17.1). Prevalence, extent and severity of impacts were higher amongst those with self-perceived malocclusion. Gender, ethnicity, and self-perceived malocclusion status were associated with PIDA score (p < 0.05). Sub-urban and rural females had significantly higher PIDA scores than sub-urban and rural males. In conclusion, majority of Malaysian young adults especially those with self-perceived malocclusion were impacted by their dental aesthetics.

Psychological impact and patient perception of occlusion and orthodontic treatment in periodontitis patients

Background: This study analyzed, in patients with periodontitis, the impact of the degree of self-perceived malocclusion, the experienced negative psychosocial impact of periodontitis, and the history and timing of orthodontic treatment. Methods: For the study were enrolled 54 patients undergoing a routine dental health visit. They answered the Negative Impact of Dental Aesthetics Scale (NIDAS), the Perception of Occlusion Scale (POS). Moreover, undergoes to the Approximal Plaque Index (API), the Gingival Bleeding Index (GBI), and the number of decayed teeth (DT) and missing teeth (MT). All data were analyzed using different statistical procedures. Results: The subjects ranging within the upper POS quartile scored higher on the GBI (contrast: P= 0.037) and DT (P= 0.028) than did those in the lower POS quartiles. Different to the patients who had minor negative impacts in the NIDAS, those with strong impacts had higher scores on the API (P<005). Compared to patients without previous orthodontic treatment, those with a history of orthodontic treatment lasting 24 months had a lower API (P <0.05), GBI and DT (each P = 0.008) scores. Conclusion: The present results suggest that self-perceived dental irregularity and the negative impact of periodontitis might affect oral health, whereas previous extensive orthodontic treatment may have favourable effects by improving dental health compliance.

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics.

ObjectivesThe study explored whether television commercials change the perception of one's own dentofacial attractiveness and to identify if it is influenced by personality traits.Materials and methodsThe sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, intellect, self-esteem and perfectionism) were assessed.ResultsIn their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR2=0.076; p=0.005; total model R2=0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect.ConclusionPsychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe malocclusion and higher cognitive abilities.

Adult orthodontic retreatment: A survey of patient profiles and original treatment failings

A growing number of adult patients are seeking orthodontic treatment. This research aimed to analyze the particulars of patients seeking retreatment and identify the causes of their original treatment failure. An online questionnaire survey of adults seeking first-time orthodontic treatment (control) and retreatment (study) was conducted. Index of complexity, outcome, and need (ICON) scores were determined. Appraisal of treatment records was carried out to identify the causes of original treatment failure. No significant differences were found between retreatment adult patients and first-timers regarding reasons for seeking orthodontic treatment, malocclusion type, self-perception of malocclusion, level of self-motivation, willingness for surgery, expectations of treatment improvement and duration. The predominant reason for seeking treatment in both groups was for aesthetic concerns. Retreatment patients presented with lower ICON scores (39.4; standard error, 0.26) than the first-time patients (54.3; standard error, 0.23), P≤0.001. The predominant reasons for original treatment failings were poor treatment, maturational changes, inadequate retention, shortcomings in diagnosis and treatment planning, and unfavorable growth. Other causes were related to transverse deficiency, secondary malocclusion (after periodontal breakdown), poor retention compliance, and temporomandibular joint degeneration. Adult orthodontic retreatment and first-time seekers' profiles are remarkably similar. Aesthetic concerns were the leading reasons patients sought treatment. ICON was not a useful proxy of patient profiles. Poor treatment was the chief reason for the failure of the original treatment. In terms of clinical significance, clinicians should be mindful of the patient profiles of retreatment seekers and vigilant about the possible causes of failings of orthodontic treatment to avoid suboptimal outcomes.

Prevalence, Extent and Severity of the Psychosocial Impact of Dental Aesthetics among Malaysian Adolescents

This study aimed to assess the prevalence, extent and severity of the psychosocial impact of dental aesthetics (PIDA) among Malaysian adolescents especially those with self-perceived malocclusion, and to determine if age and gender affected their PIDA. A cross-sectional study using a self-administered questionnaire was conducted on 12-17 year old schoolchildren from schools across Malaysia selected via a multi-stage sampling method. The questionnaire included the Malaysian Psychosocial Impact of Dental Aesthetics (Malaysian PIDA) questionnaire and the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC). The Malaysian PIDA measured four domains: (Dental Self Confidence, 6 items; Social Impact, 8 items; Psychological Impact, 6 items; and Aesthetic Concern, 2 items) to assess impacts on the oral health-related quality of life specific to malocclusion. While the IOTN-AC comprised a 10-point photographic scale to assess self-perceived malocclusion. Data analysis using SPSS version 20 was involved using complete data on 901 participants. The prevalence of PIDA was 90.0% while prevalence associated with self-perceived malocclusion was 96.0%. Impact of dental aesthetics was highest on the psychological wellbeing of the adolescents, followed by their self-confidence. In terms of the extent of impact, 14.0% reported significant impact on all four domains and 19.2% were associated with self-perceived malocclusion. The prevalence of impacts was higher in younger adolescents and females. In terms of the extent and severity of impacts, younger adolescents reported higher impacts but with small effect sizes, while differences between boys and girls were not significant.

Self-perceived malocclusion of non-orthodontic patients affects oral health-related quality of life?

Purpose: This cross-sectional study evaluates the impact of self-perceived malocclusion on oral health-related quality of life (OHRQoL) and also whether aesthetic self-assessment is similar to professional evaluation. Methods: this crosssectional study gathered 63 adults aged 18–36 years (28.68 ± 4.99), 42 women and 21 men, with no history of orthodontic treatment. OHRQoL was evaluated using the Brazilian short version of the Oral Health Impact Profile questionnaire (OHIP-14). Perception of malocclusion was evaluated using the aesthetic component of the Index of Complexity, Outcome and Need (ICON), socioeconomic status and theEconomic Classification Criteria of Brazil. Statistical analysis was conducted using the Mann–Whitney test, Spearman correlations and Wilcoxon test, with p < 0.05. Results: the overall average score and standard deviation for OHIP-14 was 5.17 (± 6.50). There was a weak correlation between the aesthetic component perceived by the participants and their evaluation of quality of life. Only the psychological domains (psychological discomfort and psychological disability) showed significant poor correlations. Gender and socioeconomic status did not affect aesthetic perception of malocclusion and OHRQoL. There was a significant difference between the professional assessments and those of participants. Conclusion: significant weak correlations between self-perceived malocclusion and OHRQoL were foundin participants who were not seeking orthodontic treatment; the greatest impacts were seen in the domains of psychological discomfort and psychological disability, and aesthetic self-perceived malocclusion was significantly less relevant than the professional evaluation in this studied group.

Need for orthodontic treatment and self-perception of malocclusion among young adults in chennai

Need for orthodontic treatment and self-perception of malocclusion among young adults in chennai

Prospective Evaluation of Psychosocial Impact after One Year of Orthodontic Treatment Using PIDAQ Adapted for Indian Population.

The impact of dental appearance, malocclusion and treatment for the same on psychological and functional well-being has drawn increasing attention over the past decade. Various psychometric instruments alongside normative indices have been used to predict orthodontic concerns. Evaluating the patients' experience during the orthodontic treatment can help us understand the true benefits and advantages of orthodontic therapy. The aim of the present study was to evaluate the change in the psychosocial impact of malocclusion using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) adapted for the Indian population after one year of fixed orthodontic treatment. This interventional study was conducted on 93 patients requiring fixed orthodontic treatment. Brazilian, Chinese, Spanish, Nepali and Moroccan versions of the PIDAQ have been published but the questionnaire is not available in Hindi. In the present study, the original PIDAQ was translated into Hindi language to adapt it for the Indian population and was validated by back translation and pretest. All the subjects answered the Hindi version of the questionnaire at pretreatment (T1) and at one year of orthodontic treatment (T2). Additionally, the Index of Orthodontic Treatment Need (IOTN) was applied to measure the severity and self-perception of malocclusion. The data were analysed using paired t-test, Wilcoxon signed rank test and Kruskal-Wallis test. Significant reduction was found in the total PIDAQ score and each factor's score (p<0.001) after one year of orthodontic treatment. There was a positive association of the psychosocial impact of malocclusion with the IOTN-AC (IOTN-Aesthetic Component). Adolescent females were found to be most concerned with their dentofacial appearance. Results showed significant improvement in the psychosocial impact of malocclusion with a reduction in the self-perceived needs of patients with orthodontic treatment. The psychometric instrument used may be recommended as an Oral Health Related Quality of Life (OHRQoL) assessment tool for the population in India for further research.

Prevalence of Malocclusion, Aesthetic Self-Perception and their Correlation among 18 to 24 Years Old College Students in Chennai

Background: Dental aesthetics plays a major role in determining facial appearance of a person. Facial appearance of a person contributes to his self-confidence and thereby provides social recognition to a person. The present study was conducted with the aim to assess the prevalence of malocclusion using Dental Aesthetic Index (DAI), aesthetic self – perception using Oral Aesthetic Subjective Impact Scale (OASIS) and to evaluate the correlation between these two scores among 18 to 24 years old college students in Chennai. Materials and methods: A cross-sectional descriptive study employing cluster random sampling was conducted among the college students in Chennai. Students aged between 18 to 24 years were clinically examined for assessing prevalence of malocclusion using (DAI) followed by assessment of self-perception of aesthetics using (OASIS) with a self-administered questionnaire. Correlation between the scores was assessed using Pearson’s correlation. Results: 573 study subjects participated in the present study, 73.8% study subjects had normal occlusion or slight malocclusion 18.2% study subjects had definitive malocclusion 6.3%) study subjects had severe malocclusion and 1.7% study subjects had very severe malocclusion. N=173 (30.2%) of the study subjects were very concerned about the appearance of their teeth. A significant positive correlation (r=0.287), (p<0.05) was observed between the DAI score and OASIS score among the study subjects. Conclusion: 8.2% of the study subjects had severe malocclusion, there is no significant difference in the prevalence of malocclusion across gender, mean OASIS score was high among female compared to males and a significant positive correlation observed between DAI and OASIS, and hence OASIS measure can be used to assess the self-perception of malocclusion.

Latino adolescents’ self-perceived malocclusion is more correlated with quality of life than are examiner assessments

Latino adolescents’ self-perceived malocclusion is more correlated with quality of life than are examiner assessments

Mediation and moderation effect of the big five personality traits on the relationship between self-perceived malocclusion and psychosocial impact of dental esthetics.

To explore the mediation and moderation effects of personality traits on the relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics. The sample included 252 subjects (62% female) aged 12-39 years. Self-perceived malocclusion was estimated using the 10-point scale Aesthetic Component of the Index of Orthodontic Treatment Need. The Psychosocial Impact of Dental Aesthetics Questionnaire was used to assess the psychological impact and the Big Five Inventory for personality traits. Moderation and mediation effects were evaluated with Pearson correlations and stepwise regression analysis, respectively. Self-perceived malocclusion ranged from 1 to 8 and was the most significant predictor of psychosocial impact of dental esthetics, whose unique contribution accounted for 11%-36.4% of variability, while age and sex accounted for 1.2%-2.5%. Personality traits had no mediating effect on this relationship. The moderating effect of agreeableness was present in the relationship between self-perceived degree of malocclusion and Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC) (ΔR2 = 0.035, 0.020, and 0.013, respectively; P < .001), while conscientiousness affected the relationship between perception of malocclusion and SI and PI (ΔR2 = 0.018 and 0.016, respectively; P < .05). In people with lower agreeableness and conscientiousness, increasing the severity of self-perceived malocclusion leads to less increase in SI and PI. In people with lower agreeableness, the increase influences AC in a similar manner. Extraversion, neuroticism, and openness do not have a moderating effect. The relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics appears to be moderated and not mediated by personality traits. Adolescents and young adults with lower agreeableness and conscientiousness seem to be less affected by the increased severity of self-perceived malocclusion, as demonstrated in reporting some psychosocial impacts.

Orthodontic treatment need and self-perception of malocclusion among nepalese young adults

Introduction: The objective of this study was to investigate the need of orthodontic treatment among young Nepalese adults by determining and comparing the threshold of esthetic impairment where orthodontic treatment would be sought by a sample of Nepalese Dental and Nursing students. Methods: Using the 10-grade esthetic component (AC) scale of the Index of Orthodontic Treatment Need (IOTN), 250 university students (100 dental and 150 nursing students) selected the level of esthetic impairment that represented the point at which they would seek orthodontic treatment. A questionnaire was answered by both the sample populations. The results obtained were compared between both groups. Results: The AC photograph Grade 4 and Grade 5 were found to be the most commonly selected threshold photographs by the nursing students and the dental students, respectively. Subjects who visited the dentist every 6 months, in both groups, were more likely to choose a threshold photograph closer to the attractive end of the scale. Conclusion: The information regarding the need and demand of orthodontic treatment allows a treatment priority to be set up to allocate appropriate resources. This study, using dental and nursing students suggests that as currently used the AC does not reflect the Nepalese general society's esthetic expectations. The results indicate that the esthetic expectations of the dental and nondental professionals differ so when using the AC of the IOTN the “no need for treatment” category should be Grades 1–3 of the AC, rather than Grades 1–4.

Aesthetic impact of malocclusion in the daily living of Brazilian adolescents

The aim of the present study was to determine the biopsychosocial impact of malocclusion on the daily living of Brazilian adolescents (14 to 18 years of age) through normative and subjective records and identify factors directly involved in the self-perception of malocclusions. Cross-sectional. Public and private schools in the city of Belo Horizonte, Brazil. The sample was made up of 403 adolescents, with no prior history of orthodontic treatment, who were selected randomly from a population of 182,291 students in the same age range. The oral impact of malocclusion was assessed using the Oral Impact on Daily Performance (OIDP), whereas clinical criteria were assessed using the Dental Aesthetic Index (DAI). Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and self-esteem was assessed using the Global Negative Self-Evaluation (GSE) scale. Other variables were assessed using questionnaires. The chi-square test, simple and multiple logistic regression analyses were used for the statistical analysis. Ninety five adolescents (24%) reported feeling embarrassed to smile (aesthetic impact). A logistic regression suggested that the following variables were directly involved in the self-perception of malocclusion: upper anterior crowding > or = 2 mm (P=0.009), median diastema > or = 2 mm (P=0.040), normative treatment need (highly desirable) (P<0.001) and low economic level (P<0.001). Negative repercussions on daily living were found in Brazilian adolescents with malocclusions affecting anterior dental aesthetics.

Self-Concept and the Perception of Facial Appearance in Children and Adolescents Seeking Orthodontic Treatment

To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need-Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients' diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. The self-perceived level of the attractiveness or "positive" feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion.