Life is full of difficult conversations which invariably arise at difficult times, and none more so than those which can arise through our interactions with patients, colleagues and staff. This presentation seeks to examine why these interactions are so challenging how best to prepare for them and also how to manage any which rise acutely out of our working day. Our capacity to manage these conversations well can influence the emotional impact on ourselves, our patients, and our team, and critically, mitigate any potentially deleterious consequences to our professional registration and reputation which may occur. Topics discussed include; Risks: Dental practitioners have an obligation to outline the possible risks and provide the necessary warnings for a patient before a course of treatment to obtain valid consent, but how can we do this predictably and well? Refusal: Sometimes we all need to accept that we are not the right person to provide the treatment for the patient, either because it falls outside our expertise and scope, or because we know that we can never meet that particular patient’s expectations and make them happy. Advising a patient of this is an uncomfortable conversation, but it is better to do so before something goes wrong, rather than after the event. Adverse Outcomes: When something goes wrong in the practice of dentistry it is imperative that you tell the patient. While they may be angry or upset, we have an obligation to be transparent and open disclosure is an essential component of professionalism. Money: It is not an unreasonable expectation of a patient to want to know how much their treatment is going to cost them these discussions can lead to surprising reactions from the patient – how can we pre-empt, negate and manage these? Plus, Complaints and collegiate interactions.