Objective: To explore the influence of immediate aesthetic restoration after crown fracture of anterior teeth trauma in children on their social confidence and peer acceptance. Methods: 70 children with anterior tooth trauma and crown fractures admitted from January 2020 to January 2025 were selected and randomly divided into the observation group (immediate aesthetic restoration) and the control group (delayed restoration), with 35 cases in each group. Through the Children's Social Confidence Scale (CSCS), the Peer Acceptance Assessment Questionnaire and parent interviews, the social confidence scores and peer acceptance of the two groups of children before repair, 3 months after repair and 6 months after repair were compared. Results: There was no statistically significant difference in the social confidence scores between the two groups before the repair (P > 0.05). The social confidence scores increased at 3 and 6 months after the modification, and the social confidence scores of the observation group were higher than those of the control group at 3 and 6 months after the modification, and the differences were statistically significant (P<0.05). Before the repair, there was no statistically significant difference in the scores of social confidence between the two groups (P > 0.05). After the modification, the scores of peer acceptance increased at 3 and 6 months, and the scores of peer acceptance in the observation group were higher than those in the control group at 3 and 6 months after the modification, with statistically significant differences (P<0.05). Before the restoration, there was no statistically significant difference in the subjective scores of oral function between the two groups of children (P>0.05). After the restoration, the subjective scores of oral function in both groups increased, and the scores in the observation group were higher than those in the control group, with statistically significant differences (P<0.05). Before the repair, there was no statistically significant difference in the scores of the psychological anxiety scale between the two groups of children (P>0.05). After the repair, the scores of the psychological anxiety scale of both groups decreased, and the score of the observation group was lower than that of the control group, and the differences were statistically significant (P<0.05). After the repair, interviews were conducted with parents. 85.7% of the parents in the observation group indicated that their children were more proactive in social activities and willing to communicate and play with peers. 60.0% of the parents in the control group observed an improvement in their children's social behaviors. The difference was statistically significant (P < 0.05). Conclusion: Immediate aesthetic restoration after crown fracture of anterior teeth trauma in children can effectively enhance the social confidence of children, improve peer acceptance, and has positive significance for the mental health development of children.