This review examines specific aspects of orthodontic treatment and periodontal health, namely the effects of orthodontic banded attachments on periodontal disease and more specifically the microflora found around the gingival margins. This review highlights critical developments in orthodontic techniques and microbiological advances which have helped clarify the interrelationships between orthodontic appliances and periodontal disease. Suggestions as to how these may be modified are made, as well as targeting specific areas for research.