OBJECTIVE: The aim of this retrospective, cross-sectional study was to investigate the prevalence of approximal carious lesions in patients after fixed multibracket therapy and in subjects without orthodontics on bitewing radiographs. MATERIAL AND METHODS: Bitewing radiographs of 104 orthodontically treated patients with fixed multibracket appliances were compared to those of 111 untreated subjects. The individuals in both groups were between 15 and 16.25 years of age when radiographs were taken. The test group with orthodontics was recruited from the archive of the Department of Orthodontics at the University of Zürich. The untreated control group was selected randomly from 16 communities in the Canton of Zürich. The approximal surfaces of the permanent premolars and molars of all subjects were assessed by two calibrated investigators. RESULTS: The average number of enamel lesions in the test group after fixed orthodontic treatment was lower than in the control group (0.57 vs. 1.85, p < 0.001). The same was found for dentin lesions (0.06 vs. 0.49, p < 0.001). The distribution of lesions was similar in both groups. CONCLUSION: Fewer approximal carious lesions were detected in the test group after fixed multibracket appliances than in the age-matched control group without orthodontic treatment.