Integrating behavioral and pharmacological therapeutic modalities.

Fear of dental procedures and associated anxiety are widely accepted as important deterents to optimal oral health. Such health care-related fears and anxieties are also common in many areas of medicine. For both medical and dental care a large body of psychologically derived therapeutic modalities have evolved. These methods have been shown to interact positively with pharmacological therapies also designed to help patients better tolerate medical and dental treatment. Despite these findings, behavioral interventions have not found widespread acceptance in medical and dental practice. A multidimensional model which emphasizes the simultaneous consideration of pharmacologic, psychologic, and clinical dental factors is suggested in order to arrive at therapeutic decisions. Further research could address more powerful behavioral modalities, safer pharmacologic methods, and behavioral and pharmacologic combinations which interact optimally for particular clinical conditions.