Objective To explore the effect of pulsed dental irrigator combined with refined nursing in orthodontic patients. Methods A total of 80 patients who received orthodontic treatment in our hospital from January to December 2023 were selected as the research objects. According to different nursing methods, they were divided into control group and observation group, with 40 patients in each group. The control group was given routine nursing, and the observation group was given pulsed oral irrigator combined with refined nursing. The incidence of gingivitis, enamel demineralization, tooth aesthetics, oral health status, tooth function and postoperative symptom scores were compared between the two groups. Results The incidence of gingivitis and enamel demineralization in the observation group was lower than that in the control group (P <0.05). The score of tooth aesthetics in the observation group was higher than that in the control group (P <0.05). The gingival index and plaque index of the observation group were lower than those of the control group (P <0.05). The scores of language function and masticatory function in the observation group were higher than those in the control group (P <0.05). The postoperative symptom scores and total scores of the observation group were lower than those of the control group (P <0.05). Conclusion The application value of pulsed oral irrigator combined with refined nursing in orthodontic patients is accurate, which can effectively reduce the incidence of gingivitis and enamel demineralization, improve the oral health status of patients, and has positive significance for improving oral function and tooth aesthetics.