Objectives: This study aimed to determine whether imperfections in the anterior dentition affect the emotional and/or social well being of school going children in Amritsar district of Punjab, India. Methods: A total of 2582 children between the ages 10 and 15 years of both genders were examined. Of these, 528 children with esthetic imperfections were asked a series of questions to assess their emotional and social disposition, with respect to children with no esthetic defects. Results: Females were more shy if they did not have a perfect anterior dentition (p = 0.000). Low socioeconomic status corresponded with gender (females) in determining emotional insecurity. Malocclusion was the most common cause of aesthetic defects (291/528 children), followed by causes such as, hypoplasisa/ hypocalcification, stains, peg shaped, microdontia, congenitally missing (46.4%), trauma (30.5%) and caries (1.2%). Irrespective of cause of defect, 53.8% of children were emotionally affected, in that, were fearful of being teased by other children (77.1%).