Atraumatic restorative treatment (ART) is an alternative treatment for dental caries used to remove demineralized and insensitive outer carious dentin with hand instruments only. Therefore, no electricity or anesthesia is required and pain, usually experienced in conventional cavity preparation, is kept to a minimum. Originally, ART was developed for use in developing rural countries because it does not require local anesthesia or electricity. More recently, ART has become increasingly accepted in developed countries because of its “atraumatic” approach in relation to stress and pain experienced by patients. ART preserves tooth structure, minimizing trauma, and has been found to reduce pain perhaps due to the creation of smaller cavities. This technique has been found to be useful in children, elderly patients, patients with special needs and those patients with fear and anxiety when having a dental treatment. In comparison to conventional therapy pain and anxiety are significantly lower in both children and adults who receive ART therapy. Overall, patients feel less fear and discomfort when receiving ART compared to use of conventional rotary instruments. Only hand instruments are used to remove carious tooth substance and anesthesia is not necessary. The cavity is filled and adjacent enamel fissures are sealed with conventional self-hardening glass ionomer restorative cement. Initial studies show a high efficiency of ART restorations with GIC in first-degree cavities regarding both milk and permanent teeth. Little information is available about the use of materials other than GIC in this method. Hence GIC (glass ionomer cement) is the filling material of choice for ART. Where indicated, HVGIC ART can be used as well as traditional restorations. ART offers a much more acceptable start to dental treatment than the traditional „injection, drill and fill“ approach.