Background: Manual dexterity is important for dentists. However, few studies have investigated the relation between dental skills and manual dexterity. The hypothesis of the present study is that an association exists between manual dexterity and the accuracy of cavity preparation. Methods: Fifty-two dental students (25 males, 27 females) participated in this study. All subjects completed manual dexterity tasks (i.e., grip strength, pinch force, and number of taps made by fingers of the right hand) and a preparation accuracy test using Virtual Reality Systems (VRS, Simodont®). For the preparation test, the cross-block body in Simodont's Manual Dexterity section was used. The associations between erroneous preparations (i.e., errors in the lateral and vertical directions) and the results of manual dexterity tasks were then analyzed and examined. Result: The results revealed that grip strength and number of taps made by the fingers correlated with lateral direction errors. In particular, the number of taps in the first 10 s from the start of tapping made by the third finger, which the participants used as a finger rest during preparation, demonstrated a significant correlation with lateral direction errors. Conclusion: In this work, tapping was revealed to be associated with manual dexterity by quantifying the accuracy of preparation. In addition, the agility of the third finger used as a finger rest appeared to affect accuracy in the lateral direction. VRS is useful not only in developing teaching strategy but also in research on cavity preparation. DOI: 10.21276/aohdr.1828