Anxiety and avoidance have obvious consequences for patients' oral health. When dental treatment has been avoided for a number of years, the patient's oral health may be in a state of neglect whereby many interventions are needed, including, extractions, endodontics and surgical procedures. The prospect of undergoing such invasive interventions can have a significant detrimental effect on the patient's emotional wellbeing. In the assessment phase it is therefore important to assess to what extent the patient is able to cope with adverse or negative events, whether internal and external resources are available and what the level of motivation is for overcoming their fear as well as for dental treatment. Since additional psychological problems can limit the patient's psychological resilience and coping resources, one has to establish whether the dental treatment and possibly other personal or work related problems are likely to be too demanding or overwhelming for the patient. For this reason it is important to establish whether the patient's dental anxiety or fear is the only presenting problem, or whether the patient displays intrusive and interfering psychiatric symptoms.