Comparative evaluation of assessing caries removal efficiency and pain perception in 6-8 years old children using carbide bur, diamond burs, smart bur and ceramic bur:A randomized clinical study

Dental caries is one of the most common chronic conditions affecting children globally, particularly between 6 to 8 years of age. Effective caries removal with minimal discomfort is essential in pediatric dentistry to ensure child cooperation and prevent dental fear. Conventional burs such as carbide and diamond are efficient but often cause pain and anxiety. Newer minimally invasive instruments like smart burs and ceramic burs offer promising alternatives by preserving healthy dentin and reducing pain.

This randomized clinical trial aims to compare four types of burs—carbide, diamond, smart, and ceramic—in terms of caries removal efficiency and pain perception in 6–8-year-old children. Eighty cooperative children with occlusal dentinal caries in mandibular primary molars will be randomly assigned to one of the four groups. Pain will be assessed using the Wong-Baker FACES scale and FLACC scale, while clinical effectiveness will be evaluated using caries detection dye and a validated scoring system. The time taken for caries removal and the behavioral response (Frankl scale) will also be recorded.

The study is designed to provide evidence-based recommendations for pediatric dentists in selecting child-friendly caries excavation methods that balance clinical efficiency with patient comfort.