Objective To analyze the effect of silicone rubber guide on the aesthetic appearance in patients undergoing aesthetic restoration of anterior teeth. Methods A total of 100 patients undergoing aesthetic restoration of anterior teeth who were treated in Stomatological Hospital Affiliated to Suzhou Vocational Health College from January 2022 to June 2024 were selected as the research subjects, and they were divided into the reference group (n =50) and the study group (n =50) by the random number table method. The reference group was treated with traditional composite resin filling, and the study group was treated with silicone rubber guide. The aesthetic appearance, occlusal force, masticatory efficiency, clinical efficacy and adverse reaction rate were compared between the two groups. Results At 6 months after restoration, the scores of aesthetic appearance score of anterior teeth restoration in the study group were lower than those in the reference group (P <0.05). At 6 months after restoration, the occlusal force and masticatory efficiency of the study group were better than those of the reference group (P <0.05). The excellent and good rate of the study group (98.00%) was higher than that of the reference group (86.00%) (P <0.05). The incidence of adverse reactions in the study group (2.00%) was lower than that in the reference group (16.00%) (P <0.05). Conclusion In aesthetic restoration of anterior teeth, the application of silicone rubber guide can effectively improve the clinical effect and the aesthetic appearance of anterior teeth restoration, while enhancing occlusal force and masticatory efficiency, with high safety. It is worthy of clinical application.