Simulation, depending on the modality and fidelity of the scenarios, is an important resource for clinical teaching and achievement of learning outcomes in dentistry. The objectives of this study were to compare the degree of realism perceived by students and teachers in a simulated scenario, and to assess the level of competence acquired by the students. Method: In the Pediatric Dentistry course, eight clinical scenarios were carried out, each one using a modified Erler Zimmer child simulator (handmade), a professional actress and two students (dentist and assistant) on the same pediatric dentistry case consisting of a pulp abscess in tooth 8.5. A total of 114 students in the 4th year of dentistry studies participated in the pediatric dentistry course. Questionnaires with Likert-type answers were elaborated to evaluate the educational intervention, applying them before and after the simulation. Results: The realism best valued by the students was that of the simulated participant and the worst that of the manikin, the latter being strongly related to the realism of the office. It was observed that students' perception of clinical competence increased as the overall realism of the scenario increased (p-value = 0.00576). Conclusion: This research suggests that the creation of scenarios using handmade mannequins and simulated participants achieves a high level of realism, increasing the level of clinical competence perceived by dental students.

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