From Anticipation to Relief: Anxiety Reduction and Patient Experience as Indicators of Trust During Dental Extractions in Orthodontic Treatment

Trust is central to healthcare encounters involving fear and uncertainty. This quasi-experimental study evaluated changes in anxiety before and after dental extractions performed during orthodontic treatment planning and examined whether patient experience factors were associated with post-extraction anxiety. Fifty patients aged 11–40 years undergoing fixed orthodontic treatment requiring extraction were recruited consecutively at a tertiary care hospital from October 2023 to June 2024. Anxiety was measured immediately before and after extraction using the Beck Anxiety Inventory. Post-procedure patient experience was assessed with a structured questionnaire addressing reassurance, communication, privacy, shared decision-making, perceived understanding, and overall experience. Paired t-tests and simple linear regression were applied at p ≤ 0.05. Mean anxiety scores decreased significantly from 18.84 ± 4.09 before extraction to 13.12 ± 4.55 after extraction (p ≤ 0.001), indicating a transition from anticipatory distress to post-procedural relief. Most participants reported positive experiences, including feeling reassured (60%) and well cared for (66%). Positive overall patient experience and feeling understood by the doctor were significantly associated with lower post-extraction anxiety, whereas perceived exclusion from decision-making and lack of privacy were associated with higher anxiety. Female gender and previous painful dental experiences were associated with higher pre-extraction anxiety. These exploratory findings suggest that relational aspects of care, particularly communication, privacy, shared decision-making, and feeling understood, may influence emotional outcomes during orthodontic extractions and strengthen patient confidence through patient-centered care.