Introduction: We are currently seeing an increase in the number of patients seeking orthodontic treatment, many of whom are young adults. Besides the obvious advantages of orthodontic therapy, there are also some side effects that can be seen at the level of periodontal soft tissues, which can influence the final result. Aim of the study: The purpose of this study is to identify the main changes observed in the soft tissues during orthodontic treatment with fixed appliances (colour, size, position, texture of gingiva and shape of anterior interdental papillae), and to analyse them depending on individual clinical characteristics, gender and gingival phenotype. Material and Methods: 22 patients were included in this study – 12 women and 10 men, aged between 14 and 30 years, that presented to the Integrated Centre of Dental Medicine in Târgu Mureș, in the period 2019-2024, in search of orthodontic treatment. Results: The study found significant differences in gingival changes based on gender and gingival phenotype, with females showing more pronounced colour changes and gingival hypertrophy in the mandibular regions, and males exhibiting substantial gingival hypertrophy and colour changes, both in the frontal and lateral maxillary regions. Conclusions: This study shows gingival changes during orthodontic treatment that differ by gender and gingival phenotype. Thus, females with a thick gingival phenotype show distinct colour and size changes in the frontal mandibular region, whereas male patients tend to have more changes in the frontal and lateral maxillary regions, regardless of the gingival phenotype.