Aim: To study the effectiveness of dexmedetomidine and fentanyl as anesthetic medication in managing uncooperative children who attend dental clinics. Materials and methods: A total of 20 uncooperative pediatric patients of age range 3–7 years who had to undergo minor dental procedures were taken as study samples falling in Frankl behaviour rating scale (FBRS) were grouped into receiving dexmedetomidine (group D) and fentanyl (group F) as anesthetic-coinduction medication. Patients were prepared, and the drugs were introduced, following which various parameters such as heart rate, oxygen saturation (SpO₂), and systolic and diastolic blood were measured at baseline, onset, 10, 20, 30, 40, 50, and 60 minutes postoperatively. Sedation was evaluated by using the Ramsay sedation score, and pain was measured with the visual analog scale (VAS). Complaints of any side effects like nausea, vomiting, or any behavioral changes were evaluated and compared. Results: The mean FBRS was observed to be 1.6 and 1.4 in group D and group F, and the mean Ramsay score was 2.3 and 2.5, respectively. In group D, there was a decrease in mean heart rate from baseline to 60 minutes except at onset. There was a decrease in systolic blood pressure (SBP) in group D, whereas an increase was seen in group F, whereas a decrease in the diastolic blood pressure (DBP) in both groups. Conclusion: The effectiveness of dexmedetomidine and fentanyl as anesthetic medication in uncooperative pediatric dental patients was of similar results in terms of sedation, and the level of postoperative pain was less in children treated under dexmedetomidine. However, posttreatment complications were more common in children treated with fentanyl. Clinical significance: Both drugs showed similar results in terms of sedation. The critical value of preference for one drug over another depends on various criteria, and one such is the level of postoperative pain management that has a significant impact on the children's recovery; hence, the prevention and management of such untoward outcomes has to be met with utmost importance. However, the various drug interactions and adverse effects of using the drugs should be known to the dentist.