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The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life. The study subjects, 194 young adults aged 18–30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics. Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied.Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, Psychological Impact, and Aesthetic Concern. The factor structure was confirmed in an independent sample of 83 subjects aged 18–33 years. The reliabilities of the factor analysis-derived scales were between alpha (a) 0.85 and 0.91. They differed between respondents with varying severity of malocclusion, as assessed by subject and interviewer ratings.The results suggest that the proposed instrument, termed the ‘Psychosocial Impact of Dental Aesthetics Questionnaire’ (PIDAQ), meets the criteria of factorial stability across samples and criterion-related validity and reliability, and might be a promising tool for further research and clinical application in orthodontics.