For dental anxiety, cognitive behavioral therapy is the treatment of choice and exposure therapy is a major part of this treatment program. This article describes the underlying working mechanism of exposure therapy. Exposure should be directed toward the patient’s harm expectancies. Moreover, the patient needs to be ensured that their harm expectation will not be violated, despite being challenged to the maximum. In addition, it is important that patients perform exposure exercises in as many different contexts as possible and to ensure a lot of repetition. Combining different fear-inducing stimuli during exposure sessions is also recommended. Currently, the inhibition model is the best explanatory working mechanism model and this article contrasts the new inhibition model with the older habituation model, that is still often used in clinical practice. The most important clinical implications of the inhibition model are described and illustrated with practical examples.