The difficult patient is one who, through a variety of behaviors, provokes a series of negative feelings in most dentists. About 15% to 20% of dentist-patient encounters are considered difficult. Difficult encounters result in dissatisfaction with care, nonadherence to treatment, and poorer treatment outcomes among patients, as well as burnout, mental health problems, and reduced quality of life among dentists. Difficult encounters can be attributed to factors associated with the dentist, patient, situation, or a combination of these. Patient factors include behavioral issues (angry or argumentative, demanding, highly anxious, manipulative, hypervigilant to body sensations, etc.) and psychiatric conditions (somatic symptom disorders, depressive disorders, bipolar disorders, substance use disorders, and personality disorders). Factors related to the dentist and situational factors include poor communication skills and situational stressors. Education in behavioral medicine may empower dental students and dentists to understand and manage the factors contributing to difficult encounters.