The aim of this study was to compare the socio-demographic features and self-perception of parents concerning the malocclusion of their children with the orthodontist's opinion of normative orthodontic treatment need. The parents of 208 children (101 girls and 107 boys, between 9 and 18 years: mean 12.8 ± 2.5), who sought orthodontic treatment were asked to score the dental attractiveness of their children using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). These scores were then compared with those of the orthodontist, who also scored the Dental Health Component (DHC) of the IOTN. The influence of the socio-demographic features of the parents on both the orthodontist- and parent-rated IOTN scores was assessed. The AC grade of the IOTN and patient characteristics were tested with the Spearman's correlation coefficient (rho). The difference between the two dependent variables (orthodontists' and parents' AC grade) was compared using Wilcoxon's test. A high need for orthodontic treatment was recorded in 74.0 per cent of the subjects. Although orthodontists rated 51.4 per cent of the patients as having a severe malocclusion on aesthetic grounds, only 33.6 per cent of parents rated their child malocclusion as severe. Although socio-demographic factors were not related to the parents' perception of malocclusion, they had an influence on orthodontic treatment need as assessed by the orthodontist. Parents, in this study population, rated their children's orthodontic treatment need less severely than the orthodontist regardless of their socio-demographic characteristics. Thus, orthodontists should involve parents in the orthodontic treatment decision-making process.