Orthodontic treatment need and demand in 19-year-olds in Sweden has not previously been analysed in relation to geographic origin. The aim of this follow-up study was to examine the prevalence of self-perceived treatment need, malocclusion, earlier orthodontic treatment, self-perceived dental aesthetics and prevalence of symptoms indicative oftemporomandibular disorders in 18-19 year-olds and to analyze any differences between native born and immigrants. Body esteem and psychological wellbeing were also evaluated. The subjects, n=316, were grouped according to family origin: Group A: both parents born in Sweden (98 girls, 80 boys); Group B:the subject or at least one parent born in Eastern /South Eastern Europe (24 girls, 26 boys) and Group C: Asia (44 girls, 44 boys). Two hundered and sixty-eight participants presented for clinical examination and answered the full questionnaire, and 48 who rejected clinical examination,were interviewed by telephone using selected questions from a questionnaire. The results show that adolescents of Asian origin had a higher self-perceived treatment need than adolescents of Swedish origin. There were negligible inter-group differences with respect to frequency of malocclusion. Forty-four per cent of all participants had previously undergone orthodontic treatment, significantly more Swedish than Asian subjects. Dissatisfaction with dental aesthetics was attributed primarily to tooth colour (38 per cent) and irregular anterior teeth (34 per cent). Adolescents of Asian origin had a higher frequency of headache than those of Eastern/South Eastern European origin. Compared to boys, girls had a higher self-perceived treatment need, a higher frequency of headache and TMD and were more concerned about body appearance. Psychological wellbeing was reduced in nearly one quarter of the participants, predominantly girls: girls of Asian origin had the highest frequency. No association was found between self-perceived orthodontic treatment need and psychological wellbeing.