This study evaluated the efficacy of training in cognitive strategies for attenuating pain during orthodontic banding. Twenty-five patients, aged 8 years to 15 years-10 months, were randomly assigned to one of three groups: distraction training, reframing training, and irrelevant training control. Assessment of dental pain included heart rate, self ratings, and ratings by the orthodontist and his assistants. The results support the efficacy of cognitive strategy training in attenuating clinical pain. Compared with the controls, patients taught the cognitive strategies had lower heart rates and were rated as having less pain during the first half of the banding. Indices of pain during the procedure were correlated positively with self-reported general sensitivity to pain, and correlated negatively with motivation for braces.