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Abstract

Background
Dental anxiety is a common psychological issue that can affect how patients perceive pain and how well they cooperate during treatment. Although local anesthesia is a key method for managing discomfort in dentistry, patients with high anxiety frequently experience heightened pain sensations, even when the anesthesia has been administered effectively.
Objective
To examine how dental anxiety relates to pain perception during the administration of local anesthesia, and to assess the impact of demographic and procedural factors on this association.
Methods: A cross-sectional study was conducted on 120 adult dental patients requiring local anesthesia. Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS), and perceived pain during injection was measured using a 10-point Visual Analogue Scale (VAS). Demographics, injection type (infiltration vs. block), and previous dental experiences were recorded. Data were analyzed using Pearson correlation and multiple linear regression (SPSS v.26).Results: Mean MDAS score was 15.8 ± 4.2, indicating moderate anxiety. Mean VAS pain score was 4.9 ± 2.1. A strong positive correlation was observed between MDAS and VAS scores (r = 0.62, p < 0.001). Regression analysis showed dental anxiety was a significant predictor of pain perception (β = 0.54, p < 0.001) even after adjusting for age, gender, injection type, and dental history. Block injections and negative past dental experiences were associated with higher pain scores.Conclusion: Dental anxiety significantly amplifies perceived pain during local anesthesia. Pre-procedural anxiety management should be an integral component of dental care to enhance patient comfort and treatment outcomes.