How should a dentist best manage a highly anxious patient?

The first-line and most ethical approach to managing dental anxiety is behavioral modification through communication and tell-show-do technique. This involves explaining what will happen (tell), demonstrating with instruments before using them (show), and then performing the procedure (do). This empowers the patient, builds trust, reduces fear of the unknown, and establishes a sense of control. Anti-anxiety premedication (e.g., benzodiazepines) may be indicated for severe anxiety but is not the first-line approach and requires patient evaluation. Skipping informed consent is never appropriate. Brief appointments alone are insufficient if anxiety is not addressed.