This randomized clinical trial aims to compare two different methods of caries removal in primary molars: the chemomechanical technique using Cariclast gel and the conventional rotary drilling method. The study will evaluate and compare the pain perception, patient acceptance, and operative time associated with both techniques in children aged 5-7years.

Dental caries is one of the most common chronic diseases in children, and the management of carious lesions in primary teeth should be both effective and minimally invasive. Traditional caries removal using rotary instruments is associated with discomfort and anxiety among pediatric patients.

Chemomechanical caries removal (CMCR) agents such as Cariclast have been developed as a more conservative and less traumatic alternative. Cariclast works by softening the infected dentin chemically, allowing its gentle removal without pain or vibration.

This randomized controlled clinical trial will compare Cariclast with the conventional rotary drilling method regarding:

Pain perception assessed using the FLACC scale.

Patient acceptance evaluated using the Visual Analog Scale (VAS).

Operative time required to complete the caries removal procedure.

All procedures will be performed on cooperative children with occlusal caries in primary molars, without pulpal involvement, attending the Pediatric Dentistry Department, Faculty of Dentistry, Cairo University.

Inclusion Criteria:

• Children:

  1. children aged 4-7 years
  2. in good general health, and medically free according to parent history.
  3. Cooperative patients
  4. Children whom their parents will comply with follow-ups.
  5. Children whom their parents who accept to sign informed consent

Tooth:

1. Broad cavitated occlusal lesion with dentinal involvement
2. (Black's Class I cavity) and occlusal access.
3. Radiograph showing dentinal caries up to two-thirds of the dentinal thickness.
4. The consistency of carious lesions ranges from soft to medium hard.
5. Color of carious lesion ranges from light yellow to brown

Exclusion Criteria:

• Children:

  1. Medically or developmentally compromising conditions
  2. Children who will be unable to attend follow-up visits.
  3. Children whom their parents refuse to give written formed consent.

Teeth:

1. Cases requiring restorative treatment that is not of the Class I variety.
2. Extensively damaged teeth.
3. Radiograph showing dentinal caries of more than two thirds of the dentinal thickness.
4. Caries involving pulp or extending below the gingiva.