The aim of the study was to assess the quality of a Public Dental Service (PDS) system in Sweden with regard to the orthodontic care and to investigate the selection made for the consultation by the general practitioners (GPs) and by orthodontists of those patients with malocclusion. In the individuals leaving the PDS system, the residual need and demand for treatment due to malocclusions and satisfaction with and opinion of their teeth was assessed in orthodontically treated and untreated 19-year-olds. Altogether 121 19-year-olds were clinically investigated with respect to six defined malocclusion traits and given a questionnaire. The following results were found: Ten per cent of the 19-year-olds that had not had an orthodontic consultation showed a residual treatment need. One third of the individuals judged by the orthodontist not to need treatment and one third that had been treated by the GP showed a marked orthodontic treatment need at the age of 19 years. Twenty-two per cent of all 19-year-olds left the PDS with an orthodontic treatment need. Ninety-four per cent were satisfied with their teeth irrespective of malocclusion or not. Every second individual considered their teeth important for their self-esteem. It was concluded that 19-year-olds in general were satisfied with their dental appearance. Half of the registered residual need and demand for orthodontic treatment was not related to measurable malocclusions.