Objective To compare the effects of bracketless invisible appliance and self-ligating bracket on oral aesthetic score and periodontal health indicators in patients with mild to moderate dental crowding. Methods A total of 60 patients with mild to moderate dental crowding admitted to Hangzhou Bofan Dental Hospital from May 2020 to May 2023 were selected as the research subjects. According to different treatment methods, they were divided into the control group and the experimental group, with 30 patients in each group. The control group was treated with self-ligating bracket, and the experimental group was treated with bracketless invisible appliance. The treatment duration, periodontal health indicators, orthodontic efficacy, oral aesthetic score and complication rate were compared between the two groups. Results The treatment duration of the experimental group was longer than that of the control group (P <0.05). The plaque index and gingival index in the experimental group after treatment were lower than those in the control group (P <0.05). There was no statistically significant difference in the excellent and good rate of orthodontic treatment between the two groups (P >0.05). The oral aesthetic score of the experimental group after treatment was higher than that of the control group (P <0.05). The incidence of complications in the experimental group (10.00%) was lower than that in the control group (40.00%) (P <0.05). Conclusion For patients with mild to moderate dental crowding, the application of self-ligating bracket can shorten the treatment course. Although bracketless invisible appliance has a relatively longer treatment duration, it offers better aesthetic effect, and causes less damage to periodontal tissues, with higher safety.