Self-awareness of poorly arranged teeth can influence the quality of life. This study aimed to report the impacts of self-perceived malocclusion in young adults and the association between demographic characteristics and oral health related quality of life (OHRQoL). In this cross-sectional study, six-hundred-forty-three subjects from Selangor, Malaysia selected using a multistage sampling technique answered the Psychosocial Impact of Dental Aesthetics (PIDA) questionnaire and self-rated their dental appearance using the Aesthetic Component of the Index of Orthodontic Treatment Need. Data were analyzed using multifactorial ANOVA to identify the association between demographic characteristics and total PIDA score. Five-hundred-twenty-four subjects (81.5%) completed the questionnaires. Overall, 87.8% had impacts on their OHRQoL. Psychological impact was the most impacted domain (75.8%), followed by dental self-confidence (59.4%), social impact (48.9%) and aesthetic concern (22.1%). 16.8% reported significant impacts on all domains. Their mean PIDA score was 36.3 (SD 17.1). Prevalence, extent and severity of impacts were higher amongst those with self-perceived malocclusion. Gender, ethnicity, and self-perceived malocclusion status were associated with PIDA score (p < 0.05). Sub-urban and rural females had significantly higher PIDA scores than sub-urban and rural males. In conclusion, majority of Malaysian young adults especially those with self-perceived malocclusion were impacted by their dental aesthetics.