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Context: Dental fear is a common and imperative emotion that develop as a response to the stressful situation, which raises children's anxiety level and resulting in avoidance behavior.Aims: The aim of this study is to evaluate and compare the tell-show-do technique with and without the aid of a virtual tool in the management of pediatric dental patients.Settings and Design: Department of Pediatric and Preventive Dentistry, nonrandomized clinical trial.Subjects and Methods: A total of 90 children of the age group of 6-9 years who were in the need of restorative treatment without using local anesthesia were assigned into two groups: Control group, where tell-show-do was applied as behavior management technique and intervention group in which tell-show-do with the aid of a virtual tool was applied. Child anxiety level was assessed using a combination of anxiety rating parameters before and after the procedure. Three physiological parameters (heart rate, oxygen saturation, and respiratory rate) and two behavioral parameters (Wright's modification of Frankl' behavior Rating Scale and Facial Image Scale) were recorded.Statistical Analysis Used: Physiological parameters were analyzed using the independent sample t-test and behavioral parameters using the Mann-Whitney U-test (P < 0.05).Results: A significant difference in all five parameters was observed between the control group and intervention group.Conclusions: Virtual tool offers a new concept of virtual distraction aid in pediatric dentistry, and it was found to be very effective in managing anxious pediatric patients. This promising method diminishes the unpleasantness often associated with dental procedures and offers a relaxed state in children. [ABSTRACT FROM AUTHOR]