Objective To analyze the effect of high-quality nursing on plaque index and facial aesthetics in patients after oral and maxillofacial surgery. Methods A total of 70 patients undergoing oral and maxillofacial surgery at China-Japan Friendship Hospital from December 2021 to December 2025 were selected as the research subjects. According to the random number table method, they were divided into the conventional group and the observation group, with 35 patients in each group. The conventional group received conventional nursing, and the observation group received high-quality nursing on the basis of conventional nursing. The swallowing status, plaque index, hospitalization time, psychological status, facial aesthetics and complication rate were compared between the two groups. Results After nursing, the MDADI score in the observation group was higher than that in the conventional group (P<0.05). The PLI score in the observation group was lower than that in the conventional group (P<0.05). The hospitalization time in the observation group was shorter than that in the conventional group (P<0.05). After nursing, the scores of HAMA and HAMD in the observation group were lower than those in the conventional group (P<0.05). The scores of all dimensions of facial aesthetics in the observation group were higher than those in the conventional group (P<0.05). The incidence of complications in the observation group was lower than that in the conventional group (P<0.05). Conclusion High-quality nursing can effectively improve swallowing function, psychological status and facial aesthetics in patients after oral and maxillofacial surgery, reduce plaque index and the incidence of complications, and shorten hospitalization time.