Objective To study the effect of preoperative anxiety coping strategies in patients with orthodontic micro-screw implant anchorage. Methods A total of 64 patients with malocclusion who were treated in our hospital from May 2022 to May 2023 were randomly divided into control group and observation group, with 32 patients in each group. The control group was given routine nursing, and the observation group was given preoperative anxiety coping strategies on the basis of the control group. The preoperative anxiety, psychological state, physiological state index, compliance and satisfaction were compared between the two groups. Results The scores of anesthesia anxiety, operation anxiety and related information demand anxiety in the observation group were lower than those in the control group (P <0.05). The scores of fear, anxiety and depression in the observation group were lower than those in the control group (P <0.05). After nursing, the systolic blood pressure, diastolic blood pressure and heart rate of the observation group were better than those of the control group (P <0.05). The compliance of the observation group was 93.75%, which was higher than 71.88% of the control group (P <0.05). The scores of satisfaction after nursing in the observation group were higher than those in the control group (P <0.05). Conclusion The application of preoperative anxiety coping strategies in patients with orthodontic micro-screw implant anchorage is effective, which can effectively alleviate the preoperative anxiety of patients,improve their psychological state and physiological state indicators, and help to improve patient compliance and satisfaction. It is worthy of clinical application.