Allergic reactions to orthodontic materials can significantly impact patient safety, making thorough assessment and individualized management essential. Common allergens include nickel, chromium, cobalt, latex, and methacrylate monomers, which may cause reactions ranging from dermatitis to anaphylaxis. Type I (immediate) and Type IV (delayed) hypersensitivities require different diagnostic and management strategies, such as skin testing and vigilant monitoring. Hypoallergenic alternatives like titanium and ceramic brackets, latex-free products, and fully polymerized adhesives help minimize risks. Emergency preparedness, including the availability of epinephrine and trained staff, is vital for managing acute allergic responses. Ongoing documentation, patient education, and collaboration with healthcare professionals support long-term safety and personalized orthodontic care.