Practical patient management: the integrated approach

Pharmacologic agents have been traditionally used in dentistry for the management of patient fears. Results have been mixed, depending on the drugs and techniques used, the skill and training of the operator, and the degree of anxiety of the patient. Pharmacology alone may be unsuitable and even hazardous for some patients. All forms of sedation and anesthesia should be administered in an environment of trust, empathy, and competence in both the behavioral and clinical sciences. Such an integrated approach will result in reduced drug dosages, decreased need for multiple drug techniques, improved patient safety, and better control of anxiety. For optimum benefits, the teaching of behavioral sciences, including interpersonal and communication skills, should be integrated with the teaching of pharmacologic methods of anxiety and pain control at both undergraduate and continuing education levels.