Purpose: To develop an instrument for the assessment of perception of orofacial appearance and psychologic issues that can affect people’s judgment. Materials and Methods: A panel composed of five members (one psychologist, two prosthodontists, one orthodontist, and one final-year dental student) generated 31 items that could draw specific hypothetical dimensions. The questionnaire was self-administered by individuals attending local high schools and a university (n = 261; 26.4% men and 73.6% women) in the 14- to 28-year age range. Internal consistency, construct validity, responsiveness, and temporal stability were assessed. Results: Factorial analysis and Cronbach alpha identified four dimensions (self-esteem, perfectionism, body image, and smile appearance concern) that could be best addressed using 17 items. Internal consistency was good (α in the .70 to .80 range). The dimensions were correlated with existing instruments that measure similar constructs. In responsiveness testing, tooth whitening did not induce changes in perfectionism or body image; however, it did increase self-esteem and decrease esthetic concern (P < .05). Conclusions: The newly created instrument, Orofacial Appearance Perception Questionnaire, is a consistent and reliable short instrument that measures psychologic issues related to the perception of orofacial appearance.