As pointed out by many [1-4], orthodontic treatment involves much more than the knowledge and experience required for biomechanical movement of teeth. A successful clinical outcome with a satisfied patient also requires inherent and acquired psychosocial knowledge and interpersonal skills essential for managing the interactions among patients, clinicians, office staff, and other health professional colleagues.
With few exceptions, the training of orthodontists in principles of human behavior is generally limited to a pablum of psychology or possibly psychiatry. This deficiency is surprising, given the importance of the structure and function of the orofacial area to quality of life. The disproportionately large neuro-anatomical representation of the orofacial area in the sensory and motor homunculi , together with housing all the cranial nerves, also provides evolutionary evidence that the orofacial area is really the most essential part of the body, the remainder of the organ systems being only support systems. Thus, the mouth is essential for survival through intake of food and water; and for socialization dependent on communication through the speech apparatus provided by teeth, lips, and tongue and the muscles of facial expression for emotion. Perhaps the ultimate role in the hierarchy of needs met by both the structure and function of the orofacial area is to provide pleasure from gustation, olfaction, and sensuality, the antithesis being the sensory input associated with pain, displeasure, and disgust [6, 7]. There is also little doubt of the relation of facial morphology to self-image and the motivation to seek help from orthodontists and/or surgeons .
Beginning with some practical applications of behavioral science methodology, it is important to first determine what is in the patients’ heads regarding their perceptions of the objectively measured morphology and function of the mouth, teeth, and surrounding orofacial area. Psychologists and psychiatrists have used many different methods to determine the contribution of the perception of the orofacial area to self-image relative to other attributes, such as intellect, athletic, and artistic abilities which are included in overall self-concept. Specifically, orthodontists can use a variety of quantitative methods to assess the physical bases of perceived morphology or the ideational representation of the patients’ soft-tissue profile by self and others [4, 9-19].
Using a unique computer-imaging PERCEPTOMETRICS™ method, Miner et al.  found differences in accuracy of the self-perception of actual facial profiles and tolerance for preferred morphometric changes among patients, mothers, caretakers, and treating clinicians. This method was also used for comparing facial profile preferences of patients and clinicians among several ethnic and gender groups [12, 18, 21]. There are, of course, a number of computer imaging methods, such as 3D and 2D, photogrammetrics,...