Objective: To explore the application effect of individualized stratified nursing intervention in patients with dental and facial deformities undergoing orthognathic surgery. Method: The random number table method was used to divide 66 patients with dental and facial deformities who underwent orthognathic surgery in our hospital (from January 2024 to August 2026) into two groups: the control group (33 cases, conventional care) and the study group (33 cases, individualized stratified nursing intervention). The nursing effects were analyzed. Results: The swelling increment on the 3rd and 7th days after surgery in the study group was lower than that in the control group (P < 0.05); compared with the control group, the SAS score, SDS score, VAS score and PSQI score of the study group after nursing were all lower (P < 0.05); Nursing satisfaction: 75.76% of the control group was lower than 93.94% of the study group (P < 0.05).Conclusion: Individualized stratified nursing intervention can effectively reduce the facial swelling and pain degree after orthognathic surgery in patients with dental and facial deformities, improve sleep quality, alleviate anxiety and depression, and increase nursing satisfaction.