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Anxiety and pain related to mandibular block injections232Dental Anxiety InventoryThe S-DAI, which has been shown reliable and valid13, was used to measure dental anxiety. The S-DAI is the short version of the Dental Anxiety Inventory and consists of nine questions, answered on a 5-point rating scale, ranging from 1 (not at all) to 5 (very well). Profile of Mood StatesThe mood state of the patients was measured using the Profile of Mood States (POMS). The original POMS consisted of 65 items, which indicate six different types of changeable mood states: five negative mood states (tension, depression, anger, fatigue, and confusion) and one positive mood state (vigor).14 Later, this was converted into five mood states.15 The POMS shortform is a 32-item Dutch shortened version of the original POMS.16 For each item, patients were asked to indicate to what extent the description fits with their feeling the moment before the oral injection. The different items were answered on a 5-point rating scale. State-Trait Anxiety InventoryThe intensity of feelings of anxiety were measured using the State-Trait Anxiety Inventory (STAI) short-form.17 This form has two subscales, one to measure the state of anxiety and one to measure the anxiety trait. For the STAI-state subscale, patients were asked to answer 20 statements about their emotional state at the moment before they were given an oral injection. These statements were rated on a 4-point rating scale ranging from 1 (not at all) to 4 (very much). Physiological responseTo measure the physiological response, the Nexus-10 was used. The Nexus-10 is a multi-channel physiological monitoring and feedback platform. The Nexus allows the simultaneous measurement of multiple physiological variables such as HR, RSP, temperature, GSR, oximetry, electromyography, electroencephalography, electrocardiography, and electrooculography, depending on which of the 10 sensor channels are used. The accompanying software, called Biotrace+, can be used for physiological monitoring, data analysis, signal processing, and clinical biofeedback-neurofeedback (Mind Media BV). In this study, the Nexus-10 was connected via Bluetooth to a laptop. The data were transmitted real-time to the program Biotrace+. The HR, GSR,