## 1 Introduction  
Fear/anxiety, stress, and pain/sensitivity should be the three main considerations before any dental procedure is initiated [1, 2, 3]. Psychologists present fear and anxiety as two different constructs, whereby the latter is described as a condition experienced by individuals while preparing themselves for something to happen, usually an abnormal situation; and is expressed as a feeling of apprehension [4]. The anxiety related to dental procedures is considered to be developmentally normative and is prevalent in 54-92% of individuals [5; 6]. However, if unaddressed, it may result in long-term fear eventually leading to avoidance of dental visits [7]. Moreover, studies report that the trait of dental anxiety, has a direct effect on the level of pain before a dental procedure. Additionally, highly anxious patients may end up remembering more anxiety-provoking dental experiences [8; 9]. Tooth extraction is one of the most feared dental procedures; attributable to the belief that pain will be experienced [1]. Reports suggest that the increased anxiety level in patients undergoing tooth extraction is associated with the use of local anesthetic injections, the oral surgery procedure itself, and the expectation of postoperative pain [10; 11; 12; 13; 14; 15; 16]. Despite the fear, anxiety, and apprehension, it is sometimes essential to extract a non-restorable tooth with a deep cautious lesion and/or severe periodontitis, when failure to carry out the procedure increases the risk of the infection spreading to surrounding oral tissues, and also potentially increases the risk of systemic disease [17; 18; 19; 20]. At times, the extraction procedure becomes more complicated and time-consuming if complex surgical removal is required, thereby increasing the chances of anxiety [21]. Therefore, patient anxiety levels must be assessed and reduced before subjecting them to a tooth extraction procedure. Numerous clinical methods have been proposed and applied to reduce dental anxiety in patients undergoing tooth extractions. In certain clinical situations, general anesthesia is demanded by adult patients to manage their dental anxiety [22]. However, there are chances of post-operative weariness, drowsiness, fever, nausea, constipation, epistaxis, vomiting, and diarrhea associated with the use of general anesthesia [23; 24]. Some practitioners prefer carrying out dental extraction after inducing conscious sedation in patients through pharmacological interventions, by prescribing or administering nitrous oxide, benzodiazep, opioids, barbiturates, and alpha-2-adrenergic receptor agonists [25; 26; 27]. A systematic review on the use of conscious sedation to manage dental anxiety found that the evidence was inconclusive and the findings were contradictory [28]. There are also non-invasive and simpler ways of reducing anxiety in patients. A randomized control trial demonstrated a statistically significant reduction in postoperative anxiety levels in a group of patients who were given aromatherapy using lavender oil [29]. Nonetheless, there are adverse reactions related to the use of aromatherapy, such as estrogen activity, allergic reactions, and cytotoxicity [30; 31]. In another trial, the mean anxiety score was substantially reduced post-extraction in patients who were shown a tooth extraction video in comparison to those who received a verbal explanation of the procedure [32]. In this study, the level of anxiety was evaluated after the extraction procedure was completed. It would have been helpful to have information on the anxiety levels before the procedure but after the video, since the objective was to reduce the level of anxiety before the patients were subjected to the extraction procedure. Thus, two points were considered before determining the objective of the current experiment. First, that an unintrusive method of reducing anxiety in patients undergoing dental extractions would make the overall experience more pleasant, and could result in fewer postoperative complications [33].