Objective To observe the effect of direct layered composite resin filling technique on periodontal health in patients undergoing aesthetic restoration of anterior teeth. Methods A total of 78 patients requiring aesthetic restoration of anterior teeth admitted to Taiyuan Henglun Yuelun Stomatology Hospital from May 2025 to April 2026 were selected, and they were divided into the reference group (39 patients, 39 affected teeth) and the experimental group (39 patients, 39 affected teeth) by the random number table method. The reference group received aesthetic restoration of anterior teeth with direct non-layered composite resin filling, and the experimental group received aesthetic restoration of anterior teeth with direct layered composite resin filling technique. The restoration effect, periodontal health and smile aesthetic satisfaction were compared between the two groups. Results The grade A rates of marginal discoloration, postoperative sensitivity, secondary caries and retention/restoration integrity in the experimental group were higher than those in the reference group (P <0.05). After restoration, the PD and AL of the two groups were better than those before restoration (P <0.05). There were no significant differences between the two groups after restoration (P >0.05). The smile aesthetic satisfaction rate of the experimental group was 92.31%, which was higher than 74.36% of the reference group (P <0.05). Conclusion The application of direct layered composite resin filling technique in aesthetic restoration of anterior teeth can improve restoration effect, which is helpful to improve the periodontal health status of patients and raise their satisfaction with smile aesthetics.