Aim <p>This review aims to evaluate the impact of various behaviour guidance techniques (BGTs) on reducing dental anxiety in paediatric patients, highlighting their effectiveness and areas for improvement.</p> Method <p>A systematic review was conducted following PRISMA guidelines, focusing on randomised controlled trials published between November 2012 and July 2024 involving children aged 6–12 in dental settings. Relevant studies were identified through comprehensive searches in MEDLINE, EMBASE, Web of Science, PubMed, and the Cochrane Library, and analysed using narrative synthesis.</p> Results <p>Eighteen studies met the inclusion criteria. Various BGTs effectively reduced dental anxiety in paediatric patients. Cognitive Behavioural Therapy (CBT), particularly as a distraction or self-help approach, was notably effective, alongside technology-based interventions like virtual reality (VR) and video modelling (VM). While sedation was also effective, CBT was preferred due to its lower risk of adverse effects.</p> Conclusions <p>This review demonstrates that a range of BGTs, including CBT, VR, and aromatherapy, effectively reduce dental anxiety in children aged 6–12. CBT, particularly when combined with technology, was the most flexible and effective method. It provided both psychological and physical benefits with few risks. Sensory interventions, such as VR and aromatherapy, show promise in enhancing patient cooperation. Traditional methods like Tell-Show-Do (TSD) remain effective, but innovative, patient-centred techniques represent a shift in paediatric dental care. Future research should prioritise cost-efficiency and broader applicability in diverse settings.</p> Clinical trial number <p>Not applicable.</p>