Objective To explore the efficacy of occlusal guidance combined with myofunctional training in early orthodontic treatment of malocclusion in children. Methods A total of 60 children with malocclusion who received early orthodontic treatment in the Department of Orthodontics, Xining Stomatological Hospital from January 2024 to January 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 children in each group. The control group received occlusal guidance orthodontic treatment, and the observation group received myofunctional training on the basis of the control group. The temporomandibular joint-related indicators, orthodontic treatment progress, masticatory function and treatment satisfaction were compared between the two groups. Results The differences of U1-SN, N-Me, N-ANS, ANS-Me, IMPA, FMIA, overjet and overbite before and after orthodontic treatment in the observation group were higher than those in the control group (P<0.05). The interdental space closure time, occlusal opening duration, alignment and leveling time, and molar displacement time in the observation group were shorter than those in the control group (P<0.05). At 12 months after treatment, the masticatory function score of the two groups was higher than that before treatment, and that of the observation group was higher than that of the control group (P<0.05). The treatment satisfaction score of the observation group was higher than that of the control group (P<0.05). Conclusion Myofunctional training based on occlusal guidance can improve the orthodontic treatment effect of malocclusion in children, accelerate the orthodontic treatment process, further improve the masticatory function of children, and help to enhance the overall treatment satisfaction, with deffnite application efffcacy.