Objective To analyze the effect of orthodontic specialist nursing combined with nutritional diet guidance on gingival aesthetic index and occlusal function coordination in patients with orthodontics. Methods A total of 136 patients with orthodontics who visited our hospital from February 2023 to November 2024 were selected, and they were divided into the reference group and the study group by the random number table method, with 68 patients in each group. The reference group received conventional nursing, and the study group received orthodontic specialist nursing combined with nutritional diet guidance on the basis of the reference group. The gingival aesthetic index, gingival bleeding index, occlusal function coordination and patient satisfaction were compared between the two groups. Results After intervention, the scores of PES and GBI in the study group were better than those of the reference group (P<0.05). After intervention, the occlusal function coordination scores of the study group were higher than those of the reference group (P<0.05). The patient satisfaction of the study group (97.06%) was higher than that of the reference group (88.24%) (P<0.05). Conclusion Orthodontic specialist nursing combined with nutritional diet guidance can improve the occlusal function coordination, gingival aesthetic index and bleeding index of patients with orthodontics, and enhance patient satisfaction.