As a person with severe mold allergies, I live in a the South where the climate naturally breeds molds.We noticed a difference when we had our ducts cleaned.The company used a vacumn type system and covered all of our vents with plastic that was held up by the suction. We had no damage, no leaking dust/dirt back into the house and it took several hours. I think if you use a reputable company it makes the world of difference. Now we use better air filters and also have a UV light to prevent mold growth on ours system.We 'd do it again when the time comes. From your car's air filter to your dryer...anything works more efficiently when it is not filthy dirty.That's just common sense.
My best advice has always been that a proper duct cleaning is a valuable investment when moving into a home (new or old), after major renovations and if the ducts have never been cleaned before. It is unlikely that there will be increased air flow, as finding major blockage is unusual, but this will eliminate this as a possible concern if there are air flow concerns. It is also true that the "dust" that is cleared out will most likely never have been distributed through the house unless there has been some work done on the ducts. What is cleared out will be pet hair, toys, clothes, construction material, and biological material (small carcasses and/or feces). Once a proper cleaning is done a follow-up is rarely necessary, but up to the home owners discression.
Some research suggests that cleaning heating and cooling system components (e.g., cooling coils, fans and heat exchangers) may improve the efficiency of your system, resulting in a longer operating life, as well as some energy and maintenance cost savings. However, little evidence exists that cleaning only the ducts will improve the efficiency of the system.