Aims: The aim of this study was to investigate the association between self-perceived dental aesthetics and self-esteem and psychosocial status among dental students, and to evaluate whether these associations differed across academic years.Methods: A total of 312 dental faculty students were included in the study using the convenience sampling method and were divided into five groups according to their academic year. The participants were administered the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), the Rosenberg Self-Esteem Scale (RSES), the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN), and a Visual Analog Scale (VAS).Results: As a result of the study, no statistically significant differences were found among the academic years in terms of self-esteem, AC, VAS, and PIDAQ scores (p>0.05). However, descriptively, first-year students showed the lowest mean scores for dental self-confidence, aesthetic concern, psychological impact, total PIDAQ, and self-esteem. In contrast, the aesthetic concern and dental self-confidence subscales were highest, whereas the social impact subscale was lowest among fifth-year students.Conclusion: In our study, although differences in theoretical knowledge and clinical exposure are expected across academic years, students’ self-perceived dental aesthetics and associated psychosocial responses were observed to remain largely stable. These findings suggest that such perceptions may be more strongly associated with individual characteristics than with academic level. Therefore, in order to better evaluate the role of academic year from a statistical perspective, future studies should re-administer the same measurement scales to the same sample groups as they progress through their education and analyze the responses comparatively with those obtained in previous years.

Background/Objectives : This study aimed to determine the awareness levels of individuals presenting to an orthodontic clinic regarding their orthodontic treatment needs and to identify the various factors contributing to the development of this awareness, particularly the developmental period. Methods: A total of 160 participants were divided into four equal age groups (n = 40 each): early adolescence, middle adolescence, late adolescence, and young adults. Participants’ subjective awareness of orthodontic treatment need was assessed using questionnaire items, the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC), and a Visual Analog Scale (VAS) for self-perceived dental aesthetics, while normative treatment need was evaluated by an expert orthodontist using the IOTN, DAI, and ICON. The primary outcome was aesthetic agreement, classified as underestimation, exact concordance, or overestimation according to the participant-minus-researcher raw IOTN-AC score difference. Sensitivity analyses allowed a ±1-point tolerance and included a pooled analysis of the two youngest age groups. Results: Researcher IOTN-AC scores correlated strongly with IOTN-DHC (ρ = 0.861; 95% CI 0.804–0.904), DAI (ρ = 0.755; 95% CI 0.664–0.827), and ICON (ρ = 0.860; 95% CI 0.802–0.903; all Holm-adjusted p < 0.001, n = 160), confirming construct alignment with normative treatment need. Subjective perception of dental irregularity and skeletal discrepancy increased significantly with age (p = 0.005 and p < 0.001). In the exploratory pooled model, the odds of underestimation rather than exact concordance were lower at 19–21 years (OR = 0.11; 95% CI 0.04–0.35) and 22–30 years (OR = 0.09; 95% CI 0.03–0.28) than at 12–18 years. The concordant perception group demonstrated higher self-referral and subjective awareness (p < 0.05). Nonetheless, these estimates remain susceptible to sparse-data bias. Conclusions: Personal awareness of morphological and skeletal discrepancies strengthens with age, with treatment-need underestimation diminishing significantly from age 19 onward in favor of concordant perception. However, conclusions specific to middle adolescence remain uncertain because exact concordance was sparse. While enhancing awareness at younger ages is hypothesized to facilitate timely intervention during active growth periods, longitudinal studies are warranted to evaluate the long-term clinical consequences of early awareness deficits on skeletal growth patterns and subsequent surgical requirements.