Psychosocial impact of dental esthetics regulates motivation to seek orthodontic treatment

•We performed a cross-sectional study with 393 Chinese adults aged 18 to 30 years.•Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was used.•Malocclusion severity was assessed with the Index of Orthodontic Treatment Need (IOTN).•Psychosocial impact of dental esthetics was important for those seeking orthodontic treatment.•Adults with low cognition of psychosocial impact might reject orthodontic treatment.

IntroductionThe aim of this study was to evaluate the psychosocial impact of dental esthetics for adults seeking orthodontic treatment.MethodsThe Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered to 393 adults, aged 18 to 30 years. The participants were divided into 2 groups: an intervention group (received orthodontic treatment) and a control group (rejected orthodontic treatment). Baseline malocclusion severity was assessed using the Index of Orthodontic Treatment Need (IOTN).ResultsThe Wilcoxon signed rank test showed no statistically significant difference between the groups for the dental health component (DHC) of the IOTN (P = 0.134). Total and subscale PIDAQ scores of the intervention group were higher than those of the control group and differed significantly in each group among the 4 IOTN-DHC grades; self-confidence scores in the control group (F = 1.802; P >0.05) were the exception. Correlations between the PIDAQ scores and the IOTN-DHC grades were strong in each group. DHC grades, psychological impact, social impact, and aesthetic concern had significant impacts on patients accepting orthodontic treatment.ConclusionsThe psychosocial impact of dental esthetics played an important role in the decision-making process of adults seeking orthodontic treatment. Importantly, participants with low self-awareness of the potential psychosocial impact rejected orthodontic treatment, despite the need for severe normative treatment.