The aim of the present study was to compare 2 caries removal techniques with regard to time required for the removal of carious tissue, total operative time, costs, and pain complaints. Material/Methods: A randomized, controlled, clinical trial was conducted with 60 permanent first molars in 7-year-old patients (n=30) with occlusal caries. Half of the teeth were submitted to chemomechanical caries removal (CMCR) using Papacarie™ and restoration using glass ionomer cement (GIC), and the other half were submitted to the conventional method (TM; drill and bur) and silver amalgam. Both groups of teeth were analyzed with regard to operative time, costs, and pain complaints. Results: Statistically significant differences between methods were found for all the parameters. Carious tissue removal and total operative time were faster with CMCR than TM. Moreover, CMCR is cheaper than TM. Only 1 patient in the CMCR group complained of pain, whereas 16 patients in the TM group had this complaint. Conclusions: Cost and operative time were significantly lower using Papacarie™ and GIC in comparison to the conventional method for removing carious tissue. These findings demonstrate the advantages of conservative treatment in permanent first molars. © Clin Exp Med Lett.