Sir, the article by Craig and Wildsmith on conscious sedation for dentistry (BDJ 2007; 203: 629) provides a useful update, but refers to conscious sedation as a 'technique for dealing with dental phobia'. Possibly the most important use of sedation, particularly in paediatric dentistry, is to help the non-phobic patient to cope with challenging treatment. A full patient assessment prior to treatment should make it possible to anticipate treatment procedures which patients may find it difficult to tolerate. By using sedation in such cases, the subsequent development of dental phobia can be prevented. Once a phobia has developed, subsequent treatment, even with sedation, becomes more difficult, and many such patients may cease dental attendance completely.