Objective To explore the effect of four-handed operation nursing on the diagnosis and treatment efficiency and comfort in patients undergoing oral restoration. Methods A total of 50 patients undergoing oral restoration admitted to Yancheng Stomatological Hospital from July 2023 to May 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 25 patients in each group. The control group received conventional nursing, and the observation group received four-handed operation nursing. The diagnosis and treatment efffciency, comfort, quality of life, adverse reaction rate and nursing satisfaction were compared between the two groups. Results The single treatment time of the observation group was shorter than that of the control group, and the accuracy rate of instrument delivery was higher than that of the control group (P<0.05). The GCQ score of the observation group after nursing was higher than that of the control group (P<0.05). The scores of each dimension of the OHIP-14 and the incidence of adverse reactions in the observation group after nursing were lower than those of the control group (P<0.05). The nursing satisfaction of the observation group (100.00%) was higher than that of the control group (84.00%) (P<0.05). Conclusion The application of four-handed operation nursing in patients undergoing oral restoration can improve clinical diagnosis and treatment efffciency, enhance patient comfort, reduce the incidence of adverse reactions, and improve patients' quality of life and nursing satisfaction.