Objective To explore the application effect of tooth preparation in oral aesthetic repair. Methods A total of 80 patients with oral aesthetic repair admitted to our hospital from October 2021 to August 2022 were randomly divided into control group and observation group, with 40 patients in each group. The control group used conventional tooth preparation methods, and the observation group reasonably selected the optimal repair plan according to the actual tooth defect of the affected finger. The treatment effect, recurrence rate and satisfaction of the two groups were compared. Results The total effective rate of the observation group was higher than that of the control group (P<0.05). The recurrence rate of the observation group was lower than that of the control group (P<0.05). The satisfaction of the observation group was higher than that of the control group (P<0.05). Conclusion The effect of tooth preparation in oral aesthetic repair is ideal, which can avoid tooth lesions caused by improper tooth preparation and improve the treatment effect and patient satisfaction.