Objective To explore the effect of resin fflling restoration combined with ffuoride application on periodontal indicators and recurrence in children with dental caries. Methods A total of 100 children with dental caries admitted to Mentougou District Maternal and Child Health Care Hospital from August 2024 to January 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 50 children in each group. The control group received resin fflling restoration, and the observation group received ffuoride application immediately after resin fflling restoration. The treatment effect, periodontal indicators, recurrence and pain intensity were compared between the two groups. Results There was no statistically signiffcant difference in the total effective rate between the two groups (P>0.05). At 6 months after intervention, the PD, PLI and GI in the observation group were all lower than those in the control group (P<0.05). The recurrence rate of the observation group (2.00%) was lower than that of the control group (14.00%) (P<0.05). At 1, 3 and 6 months after intervention, the scores of FLACC in the observation group were lower than those in the control group (P<0.05). Conclusion Resin fflling restoration combined with ffuoride application for children with dental caries does not improve the short-term treatment effect, but it can effectively reduce the risk of dental caries recurrence, alleviate pain and improve periodontal health status, which can be used as an optimized treatment plan for pediatric dental caries.