Association between preoperative dental anxiety and the time of mandibular third molar extraction

• Preoperative dental anxiety significantly prolongs mandibular third molar extraction time, with each 1-point increase in DAS-TMS adding 1.1 minutes. • The relationship between dental anxiety and operation time is nonlinear, with a threshold effect observed at a DAS-TMS score of 14.47. • High anxiety prevalence (32.4% anxious, 8.8% highly anxious) underscores the need for routine anxiety screening in oral surgery. • Managing preoperative anxiety could reduce surgical time and potentially improve postoperative outcomes.