Assessment of need for orthodontic treatment is complex and the opinion about it might differ between the orthodontist and children. Personal perception of the need for orthodontic treatment may be influenced by a variety of social, economical and cultural factors. The aim of this study was to investigate whether there is an association between normative and self-perceived orthodontic treatment need, and to evaluate the influence of age, gender and socioeconomic background on satisfaction of dental appearance and demand for orthodontic treatment. The study included 2024 schoolchildren: 1193 (657 girls and 536 boys) 10-11 year-old and 831 (450 girls, 381 boys) 14-15 year-old. The objective need for orthodontic treatment was found to be 42.6 percent while self-perceived need 35.3 percent among Lithuanian schoolchildren. Girls thought that they needed treatment more frequently than boys independent of age and living area.