A study investigating young people's perceptions of their orthodontic needs, demands and their experience of orthodontic services was conducted in Walsall and Dudley health districts, using a self-completed questionnaire. The subjects were 4812 individuals in year 10 of education (average age 15.0 years). Overall, the level of malocclusion perceived by the young people was similar to that identified by dentists in the 1993 national survey of children's dental health. The level of reported malocclusion by boys and girls, white and non-white students and students from the two districts was the same; however fewer students from the less prosperous neighborhoods reported having straight teeth, and more non-white students with irregularities wanted to have straight teeth. Although many young people reported having a malocclusion, the majority were not concerned about it. The study revealed significant differences in experience of treatment. Boys, non-white students and students from less prosperous areas were less likely to report having active orthodontic treatment. Access to specialist services was lower for the non-white students and students from less prosperous areas. A higher proportion of students treated with fixed appliances reported straight teeth after treatment than those treated by extractions alone or by removable appliance therapy.