Sustainability is rapidly moving from a background ethic to an operational imperative in healthcare. Orthodontics contributes uniquely to environmental burdens through frequent patient visits, material consumption, laboratory workflows, and energy-intensive sterilization cycles. This review synthesizes contemporary evidence and clinical strategies aimed at reducing the ecological footprint of orthodontic practice. Emphasis is placed on life-cycle assessment (LCA) data for orthodontic appliances, digital workflows, recyclable and biodegradable materials, reuse of orthodontic components, energy and water conservation, and teleorthodontics. Emerging innovations, including additive manufacturing, biodegradable polymers, nanomaterials, and green clinic design, are highlighted. Barriers such as cost, regulation, awareness, and standardization are discussed alongside future directions involving sustainability education, expanded LCA research, and eco-certification programs. Collectively, these strategies demonstrate that environmentally responsible orthodontics is achievable through clinician commitment, manufacturer collaboration, and evidence-driven policy.