Abstract: Objective: To assess the intensity of anxiety during extraction of mandibular third molar with different operation process by monitoring patients’ heart rate changes. Methods: The study included 60 patients who were extracted the mandibular third molar under local anesthesia. The heart rate was monitored continuously during treatment to measure the anxiety. Different operation processes, including narcotic injection, flap surgery, turbine using, hammer using, dental elevator using, dental forceps using, and suturing operation. Results: Significant increase of heart rate was observed during operation process of narcotic injection, hammer using, dental elevator using, and dental forceps using. It is more significant when the operation time of hammer using and dental elevator using was prolonged. Conclusion: Patients have higher levels of anxiety during the operation process of narcotic injection, hammer using, dental elevator using, and dental forceps using, which is positively correlated with the operating time.

Key words: Mandibular third molar, Tooth extraction, Heart rate