The literature concerning risk/benefit appraisal for orthodontic treatment is reviewed with respect to factors which influence dental health, social psychological well-being and the harmful effects of orthodontic treatment. There is little evidence to suggest that the absence of malocclusion is associated with a measurably higher self-esteem and life fulfillment, or with major advantages for dental health, except for a limited number of traits. With regard to treatment, small risks of iatrogenic harm exist, while the effects of partial or total failure of treatment, and the lack of long-term stability of results should not be underestimated.