Objective To evaluate the effect of orthodontic therapy combined with prosthodontics therapy in the treatment of congenital missing teeth. Methods A total of 150 patients with congenital missing teeth admitted to our hospital from March 2023 to March 2024 were selected as the research subjects, and they were randomly divided into control group (75 patients) and observation group (75 patients). The control group was treated with prosthodontics therapy, and the observation group was treated with orthodontic therapy on the basis of the control group. The clinical efficacy, clinical indexes (plaque index, debris index, aesthetics degree score, occlusal force, masticatory efficiency), language function and masticatory function recovery time, adverse reactions and treatment satisfaction rate were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.33%, which was higher than 86.67% in the control group (P<0.05). The clinical indexes of the observation group were better than those of the control group (P<0.05). The recovery time of language function and masticatory function in the observation group were shorter than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The treatment satisfaction rate of the observation group was higher than that of the control group (P<0.05). Conclusion Orthodontic therapy combined with prosthodontics therapy can enhance the treatment effect and satisfaction rate of congenital missing teeth patients, accelerate the recovery of language function and mastication function, improve their occlusal force, masticatory efficiency, quality of life and aesthetics, and have high safety.