The recognition of health related quality of life began ever since WHO expanded the definition of health in 1948. This has resulted in the paradigm shift of health and disease from a medical model to a biopsychosocial model. Oral health too denotes not merely the absence of disease but the general well being so that the person can perform functions like eating, talking and smiling and also can contribute creatively to the society. Health related quality of life is a trade-off between how long and how well people live. To explain the concept various theoretical models have been proposed, of which the conceptual model of Wilson and Cleary 1995 is a comprehensive one. Even after much research and thousands of publications the definition of oral health related quality of life is still vague. But the patient's self perception about his oral health and related life quality are significant in clinical dental practice, dental education and research. It is widely shown that oral conditions can have varied impacts on daily living. To assess this, many measures or scales are available. They differ depending on the response format, number of items, context of use and the population in which it is applied. Patient reported outcome assessment is a less developed area in clinical dentistry and research and in future it has the potential to become the primary or secondary outcome measure in clinical interventional research.

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The use of psychometric tools to assess various psychological aspects of malocclusion and treatment is increasing in orthodontics. Mere evaluation of an orthodontic patient with normative criteria is not enough; instead, the psychological status should be assessed using a questionnaire. Many generic and few condition-specific tools are available for assessing quality of life (QoL) in orthodontics. The steps involved in the development of such tools are complex and unknown to many. This article outlines the methodology involved in the development and validation of a psychometric tool for dental and orthodontic use. It also helps the clinician to translate and cross-culturally adapt an existing QoL tool to a different setting.

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