Introduction: The formation of white spot lesions (WSL) around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment. The objectives of this study were to determine patient's knowledge on risk of developing WSLs during fixed orthodontic treatment, to identify oral hygiene practice by the patients and preventive method given during treatment. Methodology: This is a cross-sectional observational study using questionnaires. Subjects were selected by convenience sampling from orthodontic patients who attended orthodontic specialist clinic in Faculty of Dentistry, USIM. Subjects who fulfilled the inclusion criteria were asked to answer the questionnaires. The knowledge assessments were on development of WSL during treatment and oral hygiene care in orthodontic patients. Results: A total of 32 subjects were given the questionnaires. Half of them did not know that wearing braces can cause formation of WSL around the brackets. For oral hygiene practiced, 96.9% brushed their teeth more than twice daily. About 75% of them stated that their orthodontists emphasized on tooth brushing technique. Conclusion: Most patients have fair knowledge about WSL as a complication of fixed orthodontic treatment and adequate oral hygiene practices. More education on awareness regarding the development of WSL during fixed orthodontic treatment will improve treatment outcome.