Objective To analyze the application of orthodontics combined with periodontal initial therapy in patients with anterior teeth displacement caused by paradentosis and its influence on periodontal indexes. Methods A total of 60 patients with anterior teeth displacement caused by paradentosis treated in Huai’an Borui Dental Clinic from October 2022 to October 2023 were selected and randomly divided into control group and study group, with 30 patients in each group. The control group was treated with periodontal initial therapy, and the study group was treated with periodontal initial therapy combined with orthodontics. The clinical efficacy, pain level, periodontal indexes and dentition conditions were compared between the two groups. Results The total effective rate of the study group was 90.00%, which was higher than 63.33% of the control group (P <0.05). After treatment, the pain score of the study group was lower than that of the control group, the scores of masticatory function, stability, comfort and aesthetics in the study group were higher than those in the control group, and the anterior teeth coverage, anterior teeth overbite, alveolar bone height, periodontal pocket depth and bleeding on probing rate in the study group were better than those in the control group (P <0.05). Conclusion For patients with anterior teeth displacement caused by paradentosis, the combination of orthodontics on the basis of periodontal initial therapy can improve the treatment effect, reduce patients’ pain, enhance the oral health condition, and improve the masticatory function, with higher comfort and aesthetics.