Objective: To highlight the potential environmental impact of different aspects of orthodontic care in the United Kingdom, outline the major barriers and challenges to reducing this impact, and summarise the possible action that could help the orthodontic community to tackle the climate change crisis. Impact: Travel, procurement and supply, material use, waste management, energy use and water consumption within dentistry have a considerable effect on the environment. There are, however, marked knowledge gaps pertaining to the impact of orthodontic treatment. Challenges: The lack of awareness of the NHS contribution to the carbon footprint and net-zero goals among healthcare workers, the NHS backlogs and budget cuts, and cross-infection control requirements particularly following the COVID-19 pandemic are some of the many challenges to making healthcare delivery more sustainable. Opportunities: By considering the triple bottom line (social, environmental and economic), incorporating the four Rs (Reduce, Reuse, Recycle, Rethink), taking practical action, including steps to educate ourselves and the wider team, and to promote research on environmental sustainability, we can get one step closer to reaching the NHS net-zero goals. Conclusion: Climate change is a global health threat with multiple contributors associated with orthodontic treatment delivery, which can be tackled on an individual, organisational and system level.