The goal of this clinical trial is to compare the effects of aromatherapy and music therapy on dental anxiety and physiological responses in patients with moderate to severe dental anxiety undergoing mandibular third molar extraction. The main questions it aims to answer are:

• Do aromatherapy and music therapy improve anxiety-related outcomes in patients with moderate to severe dental anxiety?
• Are there differences between aromatherapy and music therapy in their effects on physiological parameters during mandibular third molar extraction? Researchers will compare an aromatherapy group and a music therapy group with a control group to determine whether these interventions improve anxiety-related outcomes and physiological responses.

Participants will:

• Complete the Modified Dental Anxiety Scale (MDAS) before and after surgery.
• Receive aromatherapy, music therapy, or standard care for five minutes before the surgical procedure.
• Undergo measurement of blood pressure, heart rate, and oxygen saturation before and after surgery.
• Report intraoperative pain using a visual analog scale (VAS).

Dental anxiety is common among patients undergoing oral surgical procedures and may be associated with physiological responses that can negatively affect the patient's treatment experience. Mandibular third molar extraction is one of the most frequently performed oral surgical procedures and is often associated with moderate to severe levels of dental anxiety.

Aromatherapy and music therapy have been proposed as non-pharmacological interventions to reduce anxiety in dental settings because of their low cost, ease of implementation, and minimal risk. However, evidence comparing the effectiveness of these interventions during mandibular third molar extraction remains limited.

This clinical trial was conducted in a public hospital and included adult patients with moderate to severe dental anxiety who underwent mandibular third molar extraction. Participants were allocated to an aromatherapy group, a music therapy group, or a control group using a non-randomized allocation method. Group distribution was balanced according to sex. Dental anxiety was assessed before and after surgery using the Modified Dental Anxiety Scale (MDAS). Physiological parameters, including systolic blood pressure, diastolic blood pressure, heart rate, and oxygen saturation, were recorded before and after surgery. Intraoperative pain was also evaluated using a Visual Analog Scale (VAS).

Clinical characteristics considered in the study included age, sex, abdominal obesity, surgical duration, and mandibular third molar position according to Winter's classification (vertical, mesioangular, and horizontal).

The objective of this study was to compare the effects of aromatherapy and music therapy on dental anxiety and anxiety-related physiological responses and to provide evidence regarding the usefulness of these non-pharmacological interventions in patients undergoing mandibular third molar extraction.

Inclusion Criteria:

• Adults aged 18-38 years.
• Scheduled for mandibular third molar extraction.
• ASA I or ASA II patients.
• Moderate to severe dental anxiety according to MDAS.

Exclusion Criteria:

• Diagnosis of anxiety, depression, or psychiatric disorders.
• Use of antidepressants, antipsychotics, anticonvulsants, beta-blockers, sedatives, or anxiolytics.
• Pregnancy.
• Cognitive, visual, hearing, or language impairment interfering with questionnaire completion.
• Use of sedatives or anxiolytics within 12 hours before surgery.

Individual participant data (IPD) will not be shared because the informed consent obtained from participants did not include authorization for public data sharing. Participant confidentiality and privacy will be protected in accordance with institutional and ethical requirements.