The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Index of Orthodontic Treatment Need (IOTN) are both used to assess treatment need. Which component of the IOTN is most directly correlated with the patient-reported concerns measured by the PIDAQ?

 The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Index of Orthodontic Treatment Need (IOTN) are both used to assess treatment need. Which component of the IOTN is most directly correlated with the patient-reported concerns measured by the PIDAQ?

A. The Treatment Complexity Index (TCI)

B. The Aesthetic Component (AC)

C. The Dental Health Component (DHC)

D. The Peer Assessment Rating (PAR) Index 

The correct answer is B. The Aesthetic Component (AC)

The PIDAQ assesses patient-reported psychosocial impacts (e.g., psychological, social, and aesthetic self-consciousness) stemming from perceived dental aesthetics, making it a subjective, condition-specific OHRQoL tool. The IOTN's Aesthetic Component (AC) directly evaluates subjective aesthetic impairment via a 10-point visual scale of anterior teeth appearance (clinician-rated but perception-based), aligning closely with PIDAQ's focus on self-perceived concerns. Validation studies consistently use AC for convergent validity of PIDAQ, showing significant correlations (e.g., Spearman's ρ = 0.389, p < 0.001 in Sahoo et al., 2025; p < 0.001 in multiple adaptations like Persian, Swedish, and Indian versions). PIDAQ scores discriminate across AC grades, with higher AC scores (worse aesthetics) linked to elevated psychosocial impacts.

In contrast, the Dental Health Component (DHC) measures objective malocclusion severity for health risks, showing correlations (e.g., r = 0.72, p < 0.01 in Brown & Moerenhout, 2016) but indirectly via aesthetic proxies in severe cases. TCI and PAR are unrelated (TCI from complexity indices; PAR for malocclusion quantification). Thus, AC provides the most direct link to PIDAQ's patient-centered aesthetic concerns.