Aim- The aim of this study was to evaluate the impact of fixed orthodontic treatment on gingival health by assessing changes in visible plaque accumulation, clinically evident inflammation and gingival recession. Materials and methods- This study aimed to assess the effects of fixed orthodontic treatment on gingival health in a cohort of 60 patients preparing for orthodontic intervention. Data collection included intraoral and extraoral radiographs, along with photographic documentation, systematically recorded on separate forms. A comprehensive intraoral examination was conducted to evaluate visible plaque, clinically evident inflammation, and gingival recession, classified according to Miller's criteria. Demographic data, including age and gender, were documented to explore potential correlations with gingival health parameters. The study sought to provide a detailed understanding of how orthodontic appliances influence gingival health over time. Statistical analysis was performed using SPSS software. Results- 60 patients were included undergoing fixed orthodontic treatment, categorized into two groups: those who underwent dental extractions (n = 30) and those who did not (n = 30). The mean age in the extraction group was 15.8 years, whereas the non-extraction group had a higher mean age of 18.8 years. Both groups had an equal gender distribution, with 15 males and 15 females in each. Treatment duration varied significantly, with the extraction group requiring an average of 25.2 months, while the non-extraction group had longer treatment duration of 39.5 months. The study evaluated changes in gingival health parameters before and after fixed orthodontic treatment. Visible plaque levels increased from 2.9 pre-treatment to 5.1 post-treatment, showing a statistically significant difference (p = 0.003). Similarly, visible inflammation rose from 4.10 before treatment to 9.12 after treatment, with a significant p-value of 0.011. Gingival recession also increased, with scores rising from 0.16 pre-treatment to 0.99 post-treatment, demonstrating a statistically significant difference (p = 0.003). Conclusion- Fixed orthodontic treatment is associated with increased plaque accumulation, inflammation, and gingival recession.