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Chapter 222saturation [SpO2]). The aim of this study was to determine whether a patient with an experienced pain score ≥7 (high pain group) on a NRS also experienced a higher physiological response compared with a patient with an experienced pain score <7 (low pain group). Material and methodsParticipantsPatients cared for at the Department of Oral and Maxillofacial Surgery of Amstelland Hospital (Amstelveen, The Netherlands) who required a mandibular block injection before treatment were eligible to participate in this study. Inclusion criteria were a minimum age of 15 years and a maximum age of 65 years; the ability to read, understand, and fill out questionnaires; and willingness to participate. Data collection took place from October 19, 2012 to December 12, 2012. The study was performed with the understanding and written consent of each subject and according to the ethical principles described in the Declaration of Helsinki. The research protocol was reviewed and approved by the medical ethical committee of the Free University of Amsterdam, The Netherlands (2012/336). Expected and experienced pain and anxiety Prior to the injection, patients were asked what level of anxiety they felt and what level of pain they expected. After the injection, patients were asked what level of anxiety and pain they experienced during the injection. Answers were given on an 11-point NRS. The scale for expected pain and experienced pain ranged from 0 (no pain) to 10 (worst possible pain), as did the scale for preoperative anxiety and experienced anxiety (0 = not anxious, 10 = extremely anxious).Experience with dental injectionsTo assess patients’ previous experiences with oral injections, patients were asked to answers five different questions from the Dental Needle Experience questionnaire (DNE).12 Answers were given on a 5-point answer scale.