Objective: To investigate the effect of self-etching adhesive combined with composite resin filling on dental plaque control and restoration outcomes in children with dental caries. Methods: Totally 104 children with dental caries were enrolled. According to the treatment plan, they were divided into a control group (n=51) and an experimental group (n=52). The control group received total-etching adhesive combined with composite resin filling, while the experimental group received self-etching adhesive combined with composite resin filling. All children were followed up for 3 months. Periodontal health indicators and tooth sensitivity before and after treatment, restoration outcomes, and complications were compared between the two groups. Results: After treatment, periodontal probing depth (PD) and plaque index (PLI) decreased in both groups compared with baseline levels, and the values were lower in the experimental group (P < 0.05). Tactile values increased, while VAS scores and Schiff index decreased in the experimental group. All indices were better than those in the control group (P < 0.05). Compared to the control group, the experimental group reported a higher success rate of restoration (P < 0.05) and a lower total complication rate (P < 0.05). Conclusion: Compared with total-etching adhesive, self-etching adhesive combined with composite resin filling achieves better restoration outcomes in children with dental caries. It can effectively reduce dental plaque, decrease tooth sensitivity, and lower the complication rate. It is worthy of clinical application.