BACKGROUND: Dental fear and anxiety are common issues affecting pediatric dental care, leading to challenges in treatment delivery and patient compliance. Nonpharmacological techniques such as the tell-show-do (TSD) method and CARD™ system have emerged as effective strategies for managing child dental anxiety. AIM: This study aims to compare the effectiveness of the CARD™ system and TSD technique in managing the behavior of 6-10-year-old children during dental procedures. METHODS: Forty children requiring invasive dental treatments were randomly assigned to either the TSD technique (group 1, RESULTS: No statistically significant differences were found between the techniques regarding physiological parameters or behavioral responses. Both groups exhibited comparable oxygen saturation levels (CARD™: 98.00 ± 1.02
TSD: 98.00 ± 1.12) and pulse rates (CARD™: 87.45 ± 7.28 bpm
TSD: 90.30 ± 10.26 bpm) before procedures, with minimal changes observed postprocedure. Similarly, there were no significant differences in emotional responses assessed by the Facial Image Scale before (CARD™: 1.90 ± 0.85
TSD: 1.80 ± 0.76) or after procedures (CARD™: 2.80 ± 1.60
TSD: 2.95 ± 1.50). CONCLUSION: This study suggests that the CARD™ system and TSD technique are equally effective in managing child dental anxiety. Both methods offer viable options for reducing anxiety and enhancing cooperation during dental procedures. HOW TO CITE THIS ARTICLE: Babu A, Eagappan SAR, Srinivasan D,