Objective To analyze the effect of orthodontics combined with porcelain veneer restoration on smile aesthetic score in patients with gummy smile. Methods A total of 102 patients with gummy smile treated in the Department of Stomatology, the Third People’s Hospital of Gansu Province from April 2022 to October 2024 were selected, and they were divided into the control group and the study group by the random number table method, with 51 patients in each group. The control group was treated with orthodontics, and the study group was treated with orthodontics combined with porcelain veneer restoration. The smile aesthetic score, gingival exposure amount, restoration effect and gingival health were compared between the two groups. Results The smile aesthetic score in the study group after treatment was higher than that in the control group (P<0.05). There was no significant difference in gingival exposure amount at 2, 4, 6 and 8 months after treatment between the two groups (P>0.05). The restoration effect in the study group was better than that in the control group (P<0.05). The proportion of gingival health in the study group was higher than that in the control group (P<0.05). Conclusion Orthodontics combined with porcelain veneer restoration can effectively improve the gingival health of patients with gummy smile, and improve smile aesthetic score, without increasing gingival exposure amount. It can achieve satisfactory restoration effect, which is worthy of clinical application.