Since the invention and application of rotary instruments, the operative treatment of carious lesions has often resulted in considerable removal of tooth structure. More recently, newer techniques for removal of carious dentine have been developed in an attempt to minimise this excessive tissue loss. The following article reviews and discusses some of the techniques available to excavate demineralised dentine clinically. These methods can be classified as mechanical and non-mechanical, rotary and non-rotary and include: dental handpieces/burs, manual excavators, air-abrasion, air-polishing, ultrasonication, sono-abrasion, chemo-mechanical methods, lasers and enzymes. The advantages and disadvantages of each technique are discussed.