This study aimed to assess the impact of a Government Income Support Program in orthodontic treatment need and on adolescents' oral health-related quality of life (OHRQoL). A population-based, matched case-control study involving 309 adolescents aged 11-14 years was conducted in the northeast of Brazil (Bahia, Brazil). The case group (with impact on OHRQoL) and the control group (no impact on OHRQoL) were matched by age and sex (p>0.05) at a ratio of 2: 1 (206 controls: 103 cases). Impact on the adolescent's OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14). Families who received Bolsa Família determined their participation in Government's Income Support Program. The Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) determined the orthodontic treatment need. The data were analyzed using conditional logistic regression (p≤0.05; 90%CI). The results showed that 96.1% of adolescents in the case group and 89.3% of adolescents in the control group present orthodontic treatment need. Adolescents with a negative impact on OHRQoL are 2.75 (90%CI: 1.12-6.72) times more likely to present orthodontic treatment need than the control group. The exposure factor to Government Income Support Program did not affect the adolescent's OHRQoL. However, adolescents reported a negative impact of orthodontic treatment need in their OHRQoL.