The aim of this study was to assess the the malocclusion prevalence, orthodontic treatment need and demand among Lithuanian schoolchildren. The objectives of the study: 1) to describe the malocclusion prevalence among Lithuanian schoolchildren in 10–11 and 14–15-year old age groups; 2) to evaluate the need for orthodontic treatment among 10–11, 14–15 year-old schoolchildren in Lithuania using the ICON index; 3) to investigate the association between normative (objective) and self-perceived (subjective) orthodontic treatment need; 4) to assess the associations of age, gender, and socioeconomic factors with dental appearance satisfaction and demand for orthodontic treatment. The results showed that 77% of 10–11-year-old and 61.7% of 14–15-year-old schoolchildren had malocclusion. The treatment need among younger schoolchildren was higher than in older group. The subjective demand for orthodontic treatment among 10–11-year-old schoolchildren and 14–15-year-old schoolchildren was similar.