Background: Previous studies from various countries have shown disparities in the provision of dental care and orthodontic treatment. This study analyzes the impact of sociodemographic factors on the distribution of publicly funded specialist orthodontic treatment for children and adolescents in a mid-sized Swedish region.

Methods: A registry-based cohort study including individuals born between 2000 and 2003 was conducted in Region Östergötland, Sweden. Sociodemographic data were obtained from Statistics Sweden (SCB), while dental health information was sourced from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa). Data on specialist orthodontic treatment were extracted from dental records.

Results: The cohort comprised 16,893 individuals, with 51.5% males and 48.5% females. Specialist orthodontic treatment was initiated for 25.7% of the population (n = 4,342). Several sociodemographic factors were associated with the likelihood of receiving orthodontic treatment. Females had 1.74 times higher odds (95% CI: 1.63–1.87) than males. Individuals born in Sweden had 1.42 times higher odds (95% CI: 1.18–1.72) compared to those born abroad. Similarly, those with Swedish-born parents had 1.16 times higher odds (95% CI: 1.04–1.30) than children with foreign-born parents. Children whose mothers had a university or college education had an OR of 1.29 (95% CI: 1.12–1.48), while those whose fathers had a university or college education had an OR of 1.19 (95% CI: 1.05–1.34), compared to those whose parents had only primary or lower secondary education.

Conclusions: Males, individuals born outside Sweden, those with foreign-born parents, and whose parents had lower educational levels were less likely to receive publicly funded orthodontic treatment. These findings suggest that sociodemographic factors influenced the distribution of orthodontic care, although the role of treatment demand requires further investigation.