Objective: To explore the effects of different methods of caries removal and cavity preparation on children with dental caries and the influence on tooth sensitivity and pulp vitality. Methods: A total of 102 children with dental caries were selected as research subjects and divided into group A (n=51, traditional turbine handset therapy) and group B (n=51, chemo-mechanical therapy) according to the different methods of caries removal and cavity preparation. The perioperative indexes, repair effect after treatment, tooth sensitivity and pulp vitality before and after treatment and occurrence of complications were compared between the two groups of children. Results: In group B, the postoperative pain duration and first normal meal time were shorter than those in group A (P<0.05), and the total time required for caries removal and cavity preparation as well as FBRS score were longer or higher than those in group A (P<0.05). There was no statistically significant difference in the repair effect between group B and group A (P>0.05). At 3 months after surgery, both groups showed decreased Tactile value and Schiff score compared to before surgery (P<0.05), with group B showing lower values than group A (P<0.05). The electric pulp value was increased in both groups compared to before surgery (P<0.05), but the value was lower in group B than that in group A (P<0.05). No statistical differences in the related complications were found between group B and group A (P>0.05). Conclusion: Chemo-mechanical caries removal can more relieve intraoperative pain, stress and postoperative sensitivity compared to traditional turbine handset, with smaller interference to pulp blood flow.