This study aims to evaluate dental anxiety and stress levels in children receiving regular piano training compared with children without piano training during preventive dental treatment. A total of 80 children aged 7-11 years, including 40 children receiving piano education and 40 controls, were included in the study. All participants underwent fissure sealant application using the Tell-Show-Do behavioral guidance technique. Dental anxiety was assessed before and after treatment using the Modified Child Dental Anxiety Scale-Faces Version (MCDASf), Facial Image Scale (FIS), and physiological parameters including pulse rate, blood pressure, oxygen saturation, and body temperature. Stress levels were evaluated using the PeSSKi scale. The study investigates whether regular piano education contributes to reduced dental anxiety and stress responses in pediatric dental patients.

Inclusion Criteria:

• Children aged between 7 and 11 years
• Patients attending the Department of Pediatric Dentistry, Faculty of Dentistry,
• Recep Tayyip Erdoğan University, and participants invited from two different art schools
• Voluntary participation in the study
• Presence of fissure sealant indication in the mandibular permanent first molars
• Systemically healthy children (ASA I) with no known history of allergy
• No hearing impairment
• Cognitive ability sufficient to understand and answer questionnaire items
• Cooperative behavior classified as "Positive" or "Definitely Positive" according to the Frankl Behavior Rating Scale

Exclusion Criteria:

• Presence of any systemic disease or history of allergy
• Children classified as "Negative" or "Definitely Negative" according to the Frankl Behavior Rating Scale
• Active psychological and/or psychiatric treatment
• Physical or mental disability preventing communication or questionnaire completion