The findings and philosophy as to why a purposeful interview conducted in the dental office is desirable for the problem patient have been presented. Rapport and meaningful dialogue between dentists and patients are the first steps necessary for successful treatment. Conducting the interview with problem patients in the dental operatory may lead to one-way communication, from the dentist to the patient. The finest clinical oral health procedures may be doomed to failure when patients see themselves more as spectators than as participants in their planned over-all health care.