Objective: To explore the therapeutic effect of personalized customized hyperbolic tongue spring combined with perioral muscle function training on primary teeth retrognathia and its impact on the restoration of occlusal function in children. Methods: A prospective study was conducted on 80 children with primary tooth retrognathia from March 2020 to March 2025. They were randomly divided into an experimental group and a control group, with 40 cases in each group, using a random number table method. The control group received traditional standardized hyperbolic tongue spring treatment, while the experimental group received personalized customized hyperbolic tongue spring combined with oral muscle function training. Compare the clinical efficacy, dental morphology indicators, bite function indicators, and recurrence and satisfaction after a 6-month follow-up between two groups. Results: The total effective rate of the experimental group (97.50%) was significantly higher than that of the control group (82.50%) (P<0.05); After treatment, the anterior tooth coverage distance, anterior tooth coverage distance, and arch width in both groups increased compared to before treatment, and the experimental group was higher than the control group (P<0.05); After treatment, the maximum biting force and chewing efficiency of both groups increased compared to before treatment, and the experimental group was higher than the control group (P<0.05); The results of a 6-month follow-up showed that the recurrence rate of retrognathia in the experimental group (2.50%) was lower than that in the control group (15.00%), and in terms of satisfaction score, the experimental group was higher than the control group (P<0.05). Conclusion: Individualized customized hyperbolic tongue spring combined with perioral muscle function training has a significant effect on the treatment of primary teeth retrognathia, which can improve the dental morphology of children, enhance bite function, and reduce long-term recurrence rate. The satisfaction of children and their families is higher.