*2.3.1. Use of questionnaire*

Using reliable and easy-to-administer tools for assessment of dental anxiety at the dental setting is beneficial for the dental team [27]. Despite the presence of a number of pretreatment questionnaires for patient administration, very few dental health-care providers utilize them [28]. Using self-reported questionnaire has been reported to be useful to assist in disclosing as well as reducing dental anxiety, as it might be a way for the dental team to gently build rapport with a patient [29]. A number of self-rated tools are available and no single instrument can be regarded as a gold standard set of questions. Mentioned here are the most commonly used and have shown acceptable psychometric properties for use in different languages worldwide. These measures are simple, easy to use, and acceptable to both patients and dental team [30–32]. They include a four-item Corah's dental anxiety scale (CDAS) and a five-item modified dental anxiety scale (MDAS) which proved to be suitable for use among adults. The results can be utilized in grouping patients according to the level of dental anxiety that is *low, moderate,* and *high*. Other measures suitable for use among children are the modified child dental anxiety scale (MCDAS) containing eight questions; and a faces version of the modified child dental anxiety scale (MCDASf) that incorporates facial images on the response format, and this can be used by children as young as 3 years old [27, 29]. Use of questionnaires assists in identifying patients with dental anxiety thus allows planning for possible approaches that can be utilized for management of patients, as suggested by Newton and coworkers [33].

#### *2.3.2. Objective measures*

Measuring patients' vital signs can add into the identification of patients with dental anxiety at the dental clinic setting. These measures are assessment of blood pressure, pulse rate, pulse oximetry to assess blood oxygen levels which is affected by stress and anxiety, finger temperature, and galvanic skin response that measures skin conductance of weak electric current [29, 34].
