This study was undertaken to determine the normative and perceived orthodontic treatment need of patients in Trinidad, a Caribbean island. The study sample comprised 30 child dental health clinic patients, 30 of their accompanying parents, and 52 adult patients from other University of the West Indies clinics and the Dental Hospital in Mount Hope, Trinidad. Two clinicians used the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN) to assess normative need, and the patient's perceived needs were assessed using the Aesthetic Component (AC) of the IOTN and the Oral Aesthetic Subjective Impact Scale (OASIS). Fisher's exact test was used to determine the differences between the subgroups of the sample for both normative and perceptive treatment need. Association between normative need and perception assessment measures was tested using Spearman's correlation coefficient. Two-thirds of the sample of 112 subjects were female and each subgroup had a similar gender distribution. The results also indicate that approximately four out of five Trinidadians have a great (or very great) orthodontic treatment need. The perception of orthodontic treatment need differed significantly (P < 0.05) from normative need in this sample and this was seen more clearly when the OASIS was used.