Background: By employing an airotor eradicates caries easily and rapidly, but it also has the potential to remove the affected dentin and sound bone. Caries excavation employing the typical method is often linked with pain and discomfort for patients.

Aim: The aim is to assess pain perception and compare the effectiveness and efficiency of caries removal methods using ceramic bur, conventional bur (diamond point), and hand excavation in children between 4-9 years.

Methodology: Evaluation of time (Efficiency): Evaluation of time (Efficiency): From the start of cavity preparation until the infected dentin excavation was finished, an assistant kept track of the amount of time needed to remove caries using a stopwatch. The efficacy of caries removal in the prepared cavity was examined for any residual carious dentin using caries detecting dye. The patient's pain response during the caries removal procedure was assessed by Wong baker faces pain scale.

Results: Caries removal efficacy was efficient with respect to ceramic bur. The amount of time needed to eliminate caries by ceramic bur was the least in contrast to conventional bur and hand excavation. Regarding the pain response that the patients felt during caries excavation, there was no difference found with respect to ceramic and conventional burs and also hand excavation.

Conclusion: Diamond burs would be suitable for excavating cavities in children since they demonstrated greater efficiency and less time consuming.