Influence of Dental Aesthetics on Psychosocial Well-being in the North Indian Population

Goyal, Tanya; Ahuja, Dhruv; Rana, Anju; Mallick, Susmita; Bairwa, Uditi

doi:10.1590/pboci.2026.022

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 26 • 2026 • https://doi.org/10.1590/pboci.2026.022 linkcopy

Influence of Dental Aesthetics on Psychosocial Well-being in the North Indian Population

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To assess the impact of dental aesthetics and to identify the factors that contribute to overall well-being in the North Indian population.

Material and Methods: The psychosocial impact of dental aesthetics was evaluated using the PIDAQ, a validated questionnaire. The content validity of the PIDAQ was established using the content validity index (CVI), and its reliability was assessed using Cronbach's alpha. The PIDAQ consists of four domains: Dental Self-Confidence (DSC), Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC). Descriptive statistics and chi-square tests were employed to analyse the relationship between age groups (18-35, 36-50, and 50+) and gender with the PIDAQ scores.

Results: A total of 568 dental patients (60.4%% females and 39.6% males) participated in the study. The questionnaire showed good validity. The 18-35 age group reported higher dental self-confidence, while the 36-50 age group expressed higher concerns about social impact. The 18-35 age group reported lower psychosocial impact and aesthetic considerations. Females were more likely to express aesthetic concern.

Conclusion: Younger individuals have more positive views of their teeth than older individuals. However, females are more concerned about aesthetic concerns, while males experience a higher psychological impact and are more dissatisfied. This shows the connection between dental health, society, and self-esteem.

Keywords:
Oral Health; Orthodontists; Orthopedics; Dental Health Services.

	Age Group (years)			Total
Gender	18-35	36-50	> 50	N (%)
	N (%)	N (%)	N (%)
Male	115 (51.1)	56 (24.9)	54 (24.0)	225 (39.6)
Female	210 (61.2)	81 (23.6)	52 (15.2)	343 (60.4)
Total	325 (57.2)	137 (24.1)	106 (18.7)	568 (100.0)

		Age Group
Questions		18-35		36-50		>50		p-value
		N	%	N	%	N	%
Dental Self-Confidence
Q1. I am proud of my teeth	Little	46	14.20	35	25.50	0	0.00	0.001^*
	Not at all	14	4.30	6	4.40	13	12.30
	Somewhat	60	18.50	83	60.60	58	54.70
	Strongly	131	40.30	13	9.50	35	33.00
	Very strongly	74	22.80	0	0.00	0	0.00
Q2. I like to show my teeth when I smile	Little	55	16.90	49	35.80	27	25.50	0.001^*
	Not at all	19	5.80	34	24.80	0	0.00
	Somewhat	54	16.60	41	29.90	46	43.40
	Strongly	149	45.80	13	9.50	26	24.50
	Very strongly	48	14.80	0	0.00	7	6.60
Q3. I am pleased when I see my teeth in the mirror	Little	54	16.60	35	25.50	7	6.60	0.001^*
	Not at all	34	10.50	13	9.50	13	12.30
	Somewhat	74	22.80	76	55.50	66	62.30
	Strongly	121	37.20	13	9.50	20	18.90
	Very strongly	42	12.90	0	0.00	0	0.00
Q4. My teeth are attractive to others	Little	61	18.80	14	10.20	28	26.40	0.001^*
	Not at all	33	10.20	28	20.40	13	12.30
	Somewhat	136	41.80	76	55.50	58	54.70
	Strongly	61	18.80	13	9.50	7	6.60
	Very strongly	34	10.50	6	4.40	0	0.00
Q5. I am satisfied with the appearance of my teeth	Little	55	16.90	14	10.20	14	13.20	0.001^*
	Not at all	40	12.30	34	24.80	13	12.30
	Somewhat	115	35.40	34	24.80	38	35.80
	Strongly	60	18.50	55	40.10	34	32.10
	Very strongly	55	16.90	0	0.00	7	6.60
Q6. I find my tooth position to be very nice	Little	62	19.10	14	10.20	7	6.60	0.001^*
	Not at all	20	6.20	34	24.80	20	18.90
	Somewhat	122	37.50	34	24.80	46	43.40
	Strongly	66	20.30	48	35.00	26	24.50
	Very strongly	55	16.90	7	5.10	7	6.60
Social Impact
Q7. I hold myself back when I smile so my teeth don't show so much	Little	68	20.90	20	14.60	33	31.10	0.001^*
	Not at all	149	45.80	28	20.40	28	26.40
	Somewhat	56	17.20	20	14.60	39	36.80
	Strongly	45	13.80	49	35.80	6	5.70
	Very strongly	7	2.20	20	14.60	0	0.00
Q8. If I don't know people well, sometimes I am concerned about what they might think about my teeth	Little	41	12.60	27	19.70	7	6.60	0.001^*
	Not at all	183	56.30	63	46.00	47	44.30
	Somewhat	61	18.80	47	34.30	32	30.20
	Strongly	26	8.00	0	0.00	13	12.30
	Very strongly	14	4.30	0	0.00	7	6.60
Q9. I am afraid other people could make offensive remarks about my teeth	Little	74	22.80	55	40.10	20	18.90	0.001^*
	Not at all	189	58.20	69	50.40	41	38.70
	Somewhat	35	10.80	13	9.50%	31	29.20
	Strongly	20	6.20	0	0.00	7	6.60
	Very strongly	7	2.20	0	0.00	7	6.60
Q10. I am somewhat inhibited in social contact because of my teeth	Little	48	14.80	27	19.70	7	6.60	0.001^*
	Not at all	229	70.50	83	60.60	54	50.90
	Somewhat	35	10.80	13	9.50	38	35.80
	Strongly	6	1.80	14	10.20	7	6.60
	Very strongly	7	2.20	0	0.00	0	0.00
Q11. Sometimes I catch myself holding my hand in front of my mouth to hide my teeth	Little	20	6.20	20	14.60	7	6.60	0.001^*
	Not at all	231	71.10	83	60.60	67	63.20
	Somewhat	41	12.60	20	14.60	19	17.90
	Strongly	26	8.00	0	0.00	13	12.30
	Very strongly	7	2.20	14	10.20	0	0.00
Q12. Sometimes I think people are staring at my teeth	Little	53	16.30	55	40.10	27	25.50	0.001^*
	Not at all	197	60.60	63	46.00	40	37.70
	Somewhat	48	14.80	13	9.50	33	31.10
	Strongly	20	6.20	0	0.00	6	5.70
	Very strongly	7	2.20	6	4.40	0	0.00
Q13. Remarks about my teeth irritate me even when they are meant jokingly	Little	41	12.60	41	29.90	19	17.90	0.001^*
	Not at all	196	60.30	69	50.40	41	38.70
	Somewhat	54	16.60	13	9.50	25	23.60
	Strongly	27	8.30	0	0.00	21	19.80
	Very strongly	7	2.20	14	10.20	0	0.00
Q14. Sometimes I worry about what members of the opposite sex think about my teeth	Little	48	14.80	28	20.40	13	12.30	0.001^*
	Not at all	216	66.50	103	75.20	61	57.50
	Somewhat	34	10.50	0	0.00	25	23.60
	Strongly	13	4.00	6	4.40	7	6.60
	Very strongly	14	4.30	0	0.00	0	0.00
Psychological Impact
Q15. I envy the nice teeth of other people	Little	81	24.90	14	10.20	27	25.50	0.001^*
	Not at all	87	26.80	19	13.90	21	19.80
	Somewhat	68	20.90	97	70.80	25	23.60
	Strongly	41	12.60	0	0.00	26	24.50
	Very strongly	48	14.80	7	5.10	7	6.60
Q16. I am somewhat distressed when I see other people's teeth	Little	90	27.70	84	61.30	20	18.90	0.001^*
	Not at all	180	55.40	33	24.10	46	43.40
	Somewhat	21	6.50	20	14.60	33	31.10
	Strongly	20	6.20	0	0.00	7	6.60
	Very strongly	14	4.30	0	0.00	0	0.00
Q17. Sometimes I am somewhat unhappy about the appearance of my teeth	Little	102	31.40	41	29.90	26	24.50	0.001^*
	Not at all	135	41.50	55	40.10	33	31.10
	Somewhat	48	14.80	20	14.60	41	38.70
	Strongly	33	10.20	21	15.30	6	5.70
	Very strongly	7	2.20	0	0.00	0	0.00
Q18. I think most people I know have nicer teeth than I do	Little	128	39.40	27	19.70	19	17.90	0.001^*
	Not at all	82	25.20	55	40.10	20	18.90
	Somewhat	83	25.50	48	35.00	53	50.00
	Strongly	13	4.00	7	5.10	14	13.20
	Very strongly	19	5.80	0	0.00	0	0.00
Q19. I feel bad when I think about what my teeth look like	Little	75	23.10	28	20.40	34	32.10	0.001^*
	Not at all	175	53.80	75	54.70	33	31.10
	Somewhat	49	15.10	20	14.60	26	24.50
	Strongly	12	3.70	0	0.00	13	12.30
	Very strongly	14	4.30	14	10.20	0	0.00
Q20. I wish my teeth looked better	Little	108	33.20	20	14.60	27	25.50	0.001^*
	Not at all	75	23.10	62	45.30	13	12.30
	Somewhat	69	21.20	20	14.60	39	36.80
	Strongly	33	10.20	21	15.30	13	12.30
	Very strongly	40	12.30	14	10.20	14	13.20
Aesthetic Concern
Q21. I don't like to see my teeth in the mirror	Little	77	23.70	28	20.40	13	12.30	0.001^*
	Not at all	175	53.80	75	54.70	47	44.30
	Somewhat	41	12.60	34	24.80	33	31.10
	Strongly	25	7.70	0	0.00	6	5.70
	Very strongly	7	2.20	0	0.00	7	6.60
Q22. I don't like to see my teeth in photographs	Little	67	20.60	14	10.20	19	17.90	0.001^*
	Not at all	136	41.80	82	59.90	55	51.90
	Somewhat	55	16.90	20	14.60	19	17.90
	Strongly	54	16.60	7	5.10	13	12.30
	Very strongly	13	4.00	14	10.20	0	0.00
Q23. I don't like to see my teeth when I look at a video of myself	Little	76	23.40	21	15.30	19	17.90	0.001^*
	Not at all	155	47.70	82	59.90	48	45.30
	Somewhat	27	8.30	20	14.60	32	30.20
	Strongly	47	14.50	14	10.20	7	6.60
	Very strongly	20	6.20	0	0.00	0	0.00

		Gender
Questions		Male		Female		p-value
		N	%	N	%
Dental Self-Confidence
Q1. I am proud of my teeth	Little	60	17.50	21	9.30	0.008^*
	Not at all	20	5.80	13	5.80
	Somewhat	126	36.70	75	33.30
	Strongly	103	30.00	76	33.80
	Very strongly	34	9.90	40	17.80
Q2. I like to show my teeth when I smile	Little	77	22.40	54	24.00	0.004^*
	Not at all	39	11.40	14	6.20
	Somewhat	73	21.30	68	30.20
	Strongly	127	37.00	61	27.10
	Very strongly	27	7.90	28	12.40
Q3. I am pleased when I see my teeth in the mirror	Little	82	23.90	14	6.20	0.001^*
	Not at all	33	9.60	27	12.00
	Somewhat	92	26.80	124	55.10
	Strongly	108	31.50	46	20.40
	Very strongly	28	8.20	14	6.20
Q4. My teeth are attractive to others	Little	75	21.90	28	12.40	0.001^*
	Not at all	40	11.70	34	15.10
	Somewhat	147	42.90	123	54.70
	Strongly	48	14.00	33	14.70
	Very strongly	33	9.60	7	3.10
Q5. I am satisfied with the appearance of my teeth	Little	69	20.10	14	6.20	0.001^*
	Not at all	53	15.50	34	15.10
	Somewhat	106	30.90	81	36.00
	Strongly	67	19.50	82	36.40
	Very strongly	48	14.00	14	6.20
Q6. I find my tooth position to be very nice	Little	76	22.20	7	3.10	0.001^*
	Not at all	40	11.70	34	15.10
	Somewhat	99	28.90	103	45.80
	Strongly	79	23.00	61	27.10
	Very strongly	49	14.30	20	8.90
Social Impact
Q7. I hold myself back when I smile so my teeth don't show so much	Little	60	17.50	61	27.10	0.001^*
	Not at all	150	43.70	55	24.40
	Somewhat	60	17.50	55	24.40
	Strongly	53	15.50	47	20.90
	Very strongly	20	5.80	7	3.10
Q8. If I don't know people well, sometimes I am concerned about what they might think about my teeth	Little	48	14.00	27	12.00	0.001^*
	Not at all	169	49.30	124	55.10
	Somewhat	106	30.90	34	15.10
	Strongly	20	5.80	19	8.40
	Very strongly	0	0.00	21	9.30
Q9. I am afraid other people could make offensive remarks about my teeth	Little	94	27.40	55	24.40	0.001^*
	Not at all	189	55.10	110	48.90
	Somewhat	53	15.50	26	11.60
	Strongly	7	2.00	20	8.90
	Very strongly	0	0.00	14	6.20
Q10. I am somewhat inhibited in social contact because of my teeth	Little	48	14.00	34	15.10	0.001^*
	Not at all	228	66.50	138	61.30
	Somewhat	53	15.50	33	14.70
	Strongly	14	4.10	13	5.80
	Very strongly	0	0.00	7	3.10
Q11. Sometimes I catch myself holding my hand in front of my mouth to hide my teeth	Little	34	9.90	13	5.80	0.016^*
	Not at all	222	64.70	159	70.70
	Somewhat	53	15.50	27	12.00
	Strongly	20	5.80	19	8.40
	Very strongly	14	4.10	7	3.10
Q12. Sometimes I think people are staring at my teeth	Little	87	25.40	48	21.30	0.173
	Not at all	177	51.60	123	54.70
	Somewhat	59	17.20	35	15.60
	Strongly	14	4.10	12	5.30
	Very strongly	6	1.70	7	3.10
Q13. Remarks about my teeth irritate me even when they are meant jokingly	Little	60	17.50	41	18.20	0.565
	Not at all	189	55.10	117	52.00
	Somewhat	52	15.20	40	17.80
	Strongly	28	8.20	20	8.90
	Very strongly	14	4.10	7	3.10
Q14. Sometimes I worry about what members of the opposite sex think about my teeth	Little	41	12.00	48	21.30	0.863
	Not at all	243	70.80	137	60.90
	Somewhat	46	13.40	13	5.80
	Strongly	13	3.80	13	5.80
	Very strongly	0	0.00	14	6.20
Psychological Impact
Q15. I envy the nice teeth of other people	Little	74	21.60	48	21.30	0.001^*
	Not at all	93	27.10	34	15.10
	Somewhat	122	35.60	68	30.20
	Strongly	34	9.90	33	14.70
	Very strongly	20	5.80	42	18.70
Q16. I am somewhat distressed when I see other people's teeth	Little	117	34.10	77	34.20	0.001^*
	Not at all	180	52.50	79	35.10
	Somewhat	39	11.40	35	15.60
	Strongly	7	2.00	20	8.90
	Very strongly	0	0.00	14	6.20%
Q17. Sometimes I am somewhat unhappy about the appearance of my teeth	Little	100	29.20	69	30.70	0.015^*
	Not at all	135	39.40	88	39.10
	Somewhat	67	19.50	42	18.70
	Strongly	41	12.00	19	8.40
	Very strongly	0	0.00	7	3.10
Q18. I think most people I know have nicer teeth than I do	Little	141	41.10	33	14.70	0.001^*
	Not at all	75	21.90	82	36.40
	Somewhat	108	31.50	76	33.80
	Strongly	7	2.00	27	12.00
	Very strongly	12	3.50	7	3.10
Q19. I feel bad when I think about what my teeth look like	Little	67	19.50	70	31.10	0.001^*
	Not at all	175	51.00	108	48.00
	Somewhat	74	21.60	21	9.30
	Strongly	6	1.70	19	8.40
	Very strongly	21	6.10	7	3.10
Q20. I wish my teeth looked better	Little	108	31.50	47	20.90	0.01^*
	Not at all	95	27.70	55	24.40
	Somewhat	73	21.30	55	24.40
	Strongly	34	9.90	33	14.70
	Very strongly	33	9.60	35	15.60
Aesthetic Concern
Q21. I don't like to see my teeth in the mirror	Little	62	18.10	56	24.90	0.001^*
	Not at all	189	55.10	108	48.00
	Somewhat	67	19.50	41	18.20
	Strongly	25	7.30	6	2.70
	Very strongly	0	0.00	14	6.20
Q22. I don't like to see my teeth in photographs	Little	54	15.70	46	20.40	0.28
	Not at all	169	49.30	104	46.20
	Somewhat	59	17.20	35	15.60
	Strongly	41	12.00	33	14.70
	Very strongly	20	5.80	7	3.10
Q23. I don't like to see my teeth when I look at a video of myself	Little	61	17.80	55	24.40	0.125
	Not at all	169	49.30	116	51.60
	Somewhat	52	15.20	27	12.00
	Strongly	48	14.00	20	8.90
	Very strongly	13	3.80	7	3.10

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