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Background: The psychosocial impact of dental aesthetics (PIDA) has a significant effect on well-being and quality of life. This study aimed to explore the latent heterogeneous classes of the PIDA among adolescents and investigate the relationships among identified subtypes and sociodemographic variables, the status of left-behind children, and the clinical manifestations of malocclusion. Methods: A cross-sectional study on the PIDA among 1451 adolescents aged 11 to 12 years in elementary schools in a rural area in Guangxi, China, was conducted. The PIDA on adolescents was also investigated via latent profile analysis; each predictor was tested via ordinal logistic regression. Results: Three latent classes for the PIDA were identified: low-risk (48.2%), medium-risk (39.8%), and high-risk (11.9%) groups. There were significant differences among the three latent classes. The results revealed that being female, The duration of maternal employment outside the hometown, the largest anterior maxillary irregularity, the largest anterior mandibular irregularity, and the antero-posterior molar relationship (ORs of 1.737, 1.138, 1.117, 1.157, and OR = 1.242; P < 0.001, < 0.01, < 0.01, < 0.01 and < 0.05, respectively) had significant effects on the PIDA on adolescents. Conclusions: The occlusal features, being female and the duration of maternal employment outside the hometown are risk factors that influence the PIDA on adolescents. This provides an evidence for improving the PIDA status among rural adolescents. [ABSTRACT FROM AUTHOR]