Objectives: The purpose of the study is to investigate the relationship between appearance perception, appearance satisfaction, and self-esteem in adolescents who demand the orthodontic treatment. Methods: A total sample of 403 high school students filled out the questionnaire and data were analyzed by using SPSS ver 20.0. for n (%), chi-square test, t-test, and a logistic regression. Results: Girl students (68.3%) tended to have a higher demand for orthodontic treatment than male students (31.7%). Higher appearance perception(t=6.967, p<0.001), lower appearance satisfaction(t=-5.477, p<0.001) and lower self-esteem(t=-7.333, p<0.001) were higher in group of demand for orthodontic treatment. The logistic regression analysis revealed that a gender, self-perception of their teeth, appearance perception, and self-esteem were significantly associated with orthodontic treatment demand. Conclusions: The result of this study will provide basic data for the consideration of psychosocial factors in orthodontic treatment in adolescents.