Objective: Our purpose was to determine the orthodontic treatment need in adolescent Kuwaitis, adjusting for treatment experience and acquired need due to mesial migration or loss of the first molars, and to assess the orthodontic manpower requirements. Subjects and Methods: A population-based sample of 753 boys and 728 girls, representing about 7% of all 13- to 14-year-old Kuwaitis, was examined in a classroom setting. Orthodontic treatment need was graded according to the Dental Health Component (DHC) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Subjects with treatment experience were scored on initial study models. The DHC and AC grades were categorized in 3 groups and aggregated to 3 IOTN groups according to the highest DHC or AC group. Group 1 was labeled as ‘no need’, 2 as ‘moderate need’, and 3 as ‘definite need for orthodontic treatment’. Results: According to the IOTN, 31.1% of the subjects demonstrated a definite need and 40.2% no need for treatment. Excluding DHC group 3 categories attributed to mesial migration and/or loss of first molars, definite need was reduced to 23.9%. Definite treatment need was more prevalent when estimated according to the DHC than according to the AC, while moderate and no need were more prevalent according to the AC (p < 0.001). No gender differences were detected (p > 0.05). Conclusions: About 30% of adolescent Kuwaitis have definite need for orthodontic treatment. The prevalence may be reduced towards 25%, provided loss or mesial migration of the first molars can be prevented. About 50–60 orthodontists are needed to meet the severe need in adolescent Kuwaitis.

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