Yes, ducts can look terribly dusty. However, that dust will not become aerosolized during the normal operation of your furnace. There is an easy way to test this. Rent a particle counter and test the air flowing out of your registers before and after cleaning. You will not see any improvement in the air quality or any reduction in the airborne dust level. Think of it this way. Duct cleaning companies tell you that you need to clean your ducts when you can see a layer of dust in your ducts. Yet that very layer of dust is proof that duct cleaning is unnecessary, because that dust proves that the air movement in your furnace is not fast enough to re-aerosolize the dust.
Since most states and municipalities don’t license air duct cleaners, you need to check their professional credentials instead, such as NADCA membership. EPA recommends all duct cleaners follow NADCA standards. Member companies must keep at least one technician on staff who has passed a NADCA test. “They have to pass rigorous testing to earn the certificate, and our code of ethics is very important,” Vinick says.

I am very interested by your post. We recently had a lead inspection on our property and one thing the lead inspector suggested was to get the air ducts cleaned out. We had our ducts cleaned last year after we under went a large renovation project (since we have a toddler in the house). This year we decided to go for lead compliance and had all our lead removed (we moved out for the work). Recently, my son had a false positive lead test, which prompted us to get a lead dust inspection around the house (including having the vents dust-wiped on the inside). The levels inside the ducts weren't crazy high (but more than would be acceptable for a floor). As it turned out my son's lead levels are very low (but not zero). Is it possible however that lead dust from the inside of a vent can come out? Would this be a scenario where you think air duct cleaning would be beneficial?
WELL, this summer when I opened them up we had black dust spewing from one of the upstairs vents. It resembled the fuzz that comes off new towels. This prompted us to look into duct cleaning. We heard from someone who had it done several times, said it was worthwhile, and knew of a firm that did a good job. Clean Air America sent a single technician for the appointment and after counting registers and ducts gave me a price of $360.00 which included “sanitizing” the system (a $99 additional fee per can used). The small size of the plenum forced him to connect the 8” round vacuum hose from the truck to the 10” square opening from our humidifier unit. In hindsight, a mistake since it reduced the “negative” pressure in the system.
Air duct cleaning service providers may tell you that they need to apply chemical biocide to the inside of your ducts as a means to kill bacteria (germs) and fungi (mold) and prevent future biological growth. They may also propose the application of a "sealant" to prevent dust and dirt particles from being released into the air or to seal air leaks. You should fully understand the pros and cons of permitting application of chemical biocides or sealants. While the targeted use of chemical biocides and sealants may be appropriate under specific circumstances, research has not demonstrated their effectiveness in duct cleaning or their potential adverse health effects. No chemical biocides are currently registered by EPA for use in internally-insulated air duct systems (see Should chemical biocides be applied to the inside of air ducts?).