Objective To observe the occurrence of enamel demineralization after ffxed orthodontic treatment and analyze its risk factors. Methods A total of 200 patients who received ffxed orthodontic treatment in Karamay Second People's Hospital from January 2023 to January 2025 were selected. The incidence of enamel demineralization was counted, and the patients were divided into the demineralization group and the non-demineralization group according to the examination results. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for enamel demineralization during fixed orthodontic treatment. Results Among the 200 patients, 24 patients (38 teeth) developed enamel demineralization, with an incidence rate of 12.00%, including 18 maxillary lateral incisors, 12 maxillary central incisors, 4 mandibular premolars, and 4 mandibular canines. Among them, 22 teeth (57.89%) had demineralization around brackets, and 16 teeth (42.11%) had interproximal demineralization. Univariate analysis showed that the proportions of patients aged ≤15 years, brushing frequency ≤3 times/day, drinking sugary milk >2 times/week, drinking carbonated drinks >2 times/week, consuming sweets >2 times/week, and orthodontic treatment course >16 weeks in the demineralization group were higher than those in the non-demineralization group (P<0.05). Multivariate Logistic regression analysis showed that age, brushing frequency, drinking sugary milk, drinking carbonated drinks, consuming sweets, and orthodontic treatment course were independent risk factors for enamel demineralization (P<0.05). Conclusion The incidence of enamel demineralization after ffxed orthodontic treatment reaches 12.00%. Age, orthodontic treatment course, brushing frequency, and diet are risk factors for enamel demineralization, which cause great damage to dental health. Attention should be paid to this problem, and relevant prevention and treatment should be carried out as early as possible.