Orthodontic treatment fundamentally alters the ecological balance of the oral cavity, creating conditions that facilitate microbial accumulation and soft-tissue inflammation. As fixed appliances interfere with natural self-cleansing mechanisms, the need for personalized hygiene strategies becomes imperative. This theoretical review explores the development and effectiveness of individualized oral hygiene measures grounded in academic literature, clinical guidelines, and preventive dentistry concepts. Unlike standard instructions, individualized programs incorporate detailed assessments of patients’ behavioral characteristics, oral microbiome profiles, appliance types, and anatomical constraints. The article highlights emerging perspectives, including biofilm-targeted hygiene, risk-stratified preventive planning, and the integration of digital monitoring systems. It also examines how psychological, educational, and ergonomic factors influence hygiene performance during orthodontic treatment. The review emphasizes that individualized approaches not only improve plaque control but also reduce therapy interruptions, enhance patient autonomy, and support long-term oral health stability. The findings underscore the importance of adopting a multidimensional strategy that considers biological, behavioral, and technological determinants of hygiene efficacy in orthodontic patients.