Aim: To describe and analyze the awareness, thoughts and values influencing patients decisions to undergo orthodontic treatment with the ultimate aim of getting a deeper insight into decision making and the need to undergo orthodontic treatment. Material and Methods: All outpatients of the orthodontic department were included in the study. The questionnaire was framed under three categories namely patients concerns for orthodontic treatment, patients knowledge or awareness of different orthodontic treatment modalities and patients preferences or decisions on various orthodontic appliances. Likert type scale for awareness was used to rate the awareness level. Participants were then asked to rank their most preferred orthodontic appliance option. Four listed options included (a. Metal bracket, b. Clear bracket, c. Lingual brackets and d. Clear aligners). Result: The factors affecting patient__ampersandsignrsquo;s concern for orthodontic treatment are as follows: pain and discomfort, the appearance of braces, cost, changes in diet pattern, being teased by friends, neighbours, peer group etc., long treatment duration, skip work on the day of review, transportation for monthly review, uneasiness during smiling and speech. The mean awareness scale shows Metal braces to be highly recognized, followed by clear braces and lingual appliances while growth modification reported least appraised. Conclusion: The dentist must educate patients on new technologies available in the market which would address patients concerns about orthodontic treatment. Awareness should be created among all population groups on other orthodontic treatment modalities in particular growth modifiers.