The American Academy of Pediatric Dentistry (AAPD) recognizes that, in providing oral health care for infants, children, adolescents, and persons with special health care needs, a continuum of both non pharmacological and pharmacological behaviour guidance techniques may be used by dental health care providers. One of the most challenging aspects of dental practice is working with the “difficult”, challenging or uncooperative patient. Utilizing deep sedation/general anaesthesia in the dental office offers benefits for the patient and the dental team. Access to care may be improved. Both the number of dentists utilizing these advanced behaviour guidance techniques and the availability of surgical setting options for the operating dentist may be increased. The treatment may be scheduled more easily and efficiently. Facility charges and administrative procedures may be less than those associated with a surgical centre. Complex or lengthy treatment can be provided comfortably while minimizing patient memory of the dental procedure. By decreasing patient movement, the quality of care may be improved.