# Psychometric Evaluation of the Odia-Adapted Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ): A Cross-Sectional Study Assessing the Psychosocial Impact of Malocclusion in Eastern Indian Adolescents

## TL;DR

This study validates a new Odia-language version of a questionnaire to assess how dental appearance affects the mental health of adolescents in Eastern India.

## Contribution

The Odia-adapted PIDAQ is the first culturally validated tool for assessing dental aesthetics' psychosocial impact in Odia-speaking adolescents.

## Key findings

- The Odia PIDAQ showed good internal consistency (Cronbach’s alpha 0.72–0.78) and high test-retest reliability (ICC 0.71–0.84).
- Exploratory factor analysis confirmed a four-factor structure explaining 56.56% of total variance.
- PIDAQ scores significantly differed across malocclusion severity groups and correlated moderately with IOTN-AC scores.

## Abstract

Introduction

The psychosocial impact of dental aesthetics significantly influences adolescents' emotional well-being, self-esteem, and social interactions. While the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) has been validated across diverse populations, no version previously existed for the Odia-speaking adolescent population in Eastern India. This study aimed to translate, culturally adapt, and validate the PIDAQ for adolescents aged 10 to 13 years in Odisha.

Method

The original PIDAQ was translated and culturally adapted into Odia following forward and backward translation, expert panel review, and pilot testing. The finalized questionnaire was administered to 450 adolescents from urban and semi-urban schools in Odisha. Internal consistency was evaluated using Cronbach’s alpha, and test-retest reliability was assessed with intraclass correlation coefficients (ICC). Construct validity was determined through exploratory factor analysis, and discriminant validity was established by comparing scores across malocclusion severity categories using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) and Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC) indices. Convergent validity was evaluated by correlating PIDAQ scores with IOTN-AC scores.

Results

The Odia version of the PIDAQ demonstrated good internal consistency, with Cronbach’s alpha values ranging from 0.72 to 0.78, and high test-retest reliability (ICC ranging from 0.71 to 0.84). Exploratory factor analysis confirmed a stable four-factor structure explaining 56.56% of the total variance. Discriminant validity was demonstrated through significant differences (p < 0.001) in PIDAQ scores across malocclusion severity groups. Moderate, statistically significant correlations between PIDAQ scores and IOTN-AC scores (ρ = 0.389) confirmed convergent validity.

Conclusion

The Odia-adapted PIDAQ is a reliable, valid, and culturally appropriate tool for assessing the psychosocial impact of dental aesthetics in adolescents, with significant potential for clinical use, public health research, and policy development.