This research is a randomized controlled trial to compare the effectiveness of plaque removal between manual conventional and orthodontic toothbrushes in patients having fixed orthodontic treatment using Orthodontic Plaque Index (OPI). This study was conducted by two orthodontists at USIM Specialist Dental Clinic with almost perfect agreement level (Kappa score: 0.95). A total of 58 orthodontic patients were divided into 2 groups; first group were patients given manual conventional toothbrush (CTB) and the other were given orthodontic toothbrush (OTB). Consent obtained, and participants were instructed to follow standardized specific oral hygiene care regimes. Orthodontic Plaque Index (OPI) was then recorded during baseline(V0), 1 month (V1), 2 months (V2), and 3 months (V3) reviews for all participants. Out of 58 patients, only 26 participants (5 male and 21 female) completed the 3 review visits. Median values were used as data was not normally distributed. At baseline, both OTB and CTB group median values were 2.00±1.00. At first month review, V1 the median values for both groups maintained at 2.00±0.00. The same values maintained at second month review, V2 where OTB was 2.00±0.00 and CTB was 2.00±1.00. During last review visit, V3 the median values for OTB was 2.00±1.00 and CTB was 2.00±0.00. Overall mean values were 1.94 (SD=0.42) for the OTB group and 2.02 (SD=0.49) for CTB group. The mean’s significant differences of OPI score between two groups was compared using Mann Whitney's U test and the resulted p value was found to be insignificant (p>0.05) where p-value for OTB is 0.42 and p= 0.65 for CTB group. These results suggested that there were no significant differences in plaque removal ability between OTB and CTB in patients undergoing fixed orthodontic treatment.