Objective To analyze the effect of bracketless orthodontic treatment and traditional fixed orthodontic treatment on periodontal health index and oral function in children with malocclusion. Methods A total of 60 children with malocclusion admitted to our hospital from January 2022 to December 2023 were selected as the research subjects. According to the order of admission time, they were divided into the control group (from January to December 2022) and the research group (from January to December 2023), with 30 children in each group. The control group was given traditional fixed orthodontic treatment, and the research group was given bracketless orthodontic treatment. The treatment effect, periodontal health index, oral function and complication rate were compared between the two groups. Results The total effective rate of treatment in the research group was 96.67%, which was higher than 73.33% in the control group (P <0.05). After treatment, the plaque index, gingival index and sulcus bleeding score in the research group were lower than those in the control group (P <0.05). After treatment, the occlusal force and masticatory function in the research group were better than those in the control group (P <0.05). The incidence of complications in the research group was 3.33%, which was lower than 26.67% in the control group (P <0.05). Conclusion In the orthodontic treatment of children with malocclusion, both bracketless orthodontic treatment and traditional fixed orthodontic treatment have good effects, but the former is more effective. It can effectively improve the periodontal health index and oral function of children, and reduce the incidence of complications, which is worthy of clinical application.