Objective To explore the effect of comfortable oral treatment on pain and smile aesthetic scores in children with dental caries. Methods A total of 100 children with dental caries admitted to Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2023 to April 2025 were selected as the research subjects, and they were divided into the reference group and the intervention group by the random number table method, with 50 children in each group. The reference group received conventional oral treatment, and the intervention group received comfortable oral treatment on the basis of the reference group. The treatment compliance rate, pain and smile aesthetic scores, and fflling shedding rate were compared between the two groups. Results The treatment compliance rate of the intervention group (98.00%) was better than that of the reference group (86.00%) (P<0.05). The NRS and VAS scores of the intervention group after treatment were better than those of the reference group (P<0.05). The fflling shedding rate of the intervention group (4.00%) was lower than that of the reference group (18.00%) (P<0.05). Conclusion The application of comfortable oral treatment for children in the intervention of oral diseases can effectively reduce the discomfort of children with dental caries during treatment, improve their treatment compliance, improve pain and smile aesthetic scores, and lower the fflling shedding rate.