Objective To explore the effect of digital bracketless invisible orthodontic appliance on periodontal health indicators and orthodontic efficiency in children with early malocclusion. Methods A total of 90 children with early malocclusion who were treated in the Department of Orthodontics, the First People’s Hospital of Xining from January 2024 to January 2025 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 45 children in each group. The control group was treated with removable appliance, and the observation group received digital bracketless invisible appliance. The clinical efficacy, periodontal health indicators, orthodontic efficiency and complication rate were compared between the two groups. Results The total effective rate of the observation group (95.56%) was higher than that of the control group (82.22%) (P <0.05). At 1 month after treatment, the scores of PLI, GI and SBI in the observation group were lower than those in the control group (P <0.05). The alignment/expansion time of the observation group was shorter than that of the control group, the number of emergency visits and the total number of follow-up visits were less than those of the control group, and the success rate of the initial treatment plan was higher than that of the control group (P <0.05). The incidence of complications in the observation group (8.89%) was lower than that in the control group (24.44%) (P <0.05). Conclusion Digital bracketless invisible orthodontic appliance achieve favorable effects for children with early malocclusion. It can maintain satisfactory periodontal status, and provide desirable orthodontic efficiency, with a low incidence of complications.