## 1 Introduction  
Sound in healthcare environments is increasingly recognized as a critical factor influencing well-being, yet dental clinics remain one of the most overlooked settings for acoustic optimization [1; 2]. Characterized by intense, high-pitched mechanical noises and limited auditory insulation, dental soundscapes can generate negative physiological and psychological reactions in patients and practitioners [3]. The dental environment is uniquely vulnerable to acoustic stress due to the proximity of sound sources, the invasive nature of procedures, and often, the lack of noise-absorbing architectural features [2; 4].  
A growing body of literature has shown that elevated noise levels in dental clinics, often exceeding 80-85 dB, are associated with stress, discomfort, and even temporary hearing disturbances [5]. Studies focusing on patients' perceptions of sound in the dental setting highlight how auditory exposure is often linked to fear, helplessness, and avoidance behaviors [4]. It was further noted that the sonic environment can compromise quality assurance by hindering communication and concentration, while also intensifying patient anxiety [2]. For dental professionals, prolonged exposure to tonal and high-frequency sounds contributes to fatigue, decreased performance, and reduced job satisfaction [2; 6]. These sound-related effects are not merely occupational hazards, but systemic challenges that impact operational efficiency and patient trust [7].  
Beyond clinical concerns, the architectural and design aspects of dental clinics play a substantial role in shaping the auditory experience. Traditional dental spaces often prioritize spatial efficiency over acoustic comfort, resulting in high reverberation times and sound leakage between operators [2; 8]. Acoustic interventions, such as sound-absorbing ceiling tiles, zoning layouts, and enclosed operatories, drawn from hospital design, have been shown to enhance patient recovery and satisfaction by reducing stress-inducing stimuli [9; 10]. In parallel, the integration of biophilic and salutogenic design principles into healthcare architecture has gained momentum as a method for promoting psychological resilience and environmental sustainability [11]. Exposure to natural materials, plants, and daylight, combined with calming soundscapes such as music or water features, has been shown to improve patient mood and perception of care [12; 13; 14; 15]. These approaches extend beyond aesthetics, functioning as therapeutic tools that control sensory overstimulation, including noise-related stress [16; 17]. Furthermore, the potential for \"plant acoustics\", the concept that plants respond to and emit sound, represents an emerging frontier in designing responsive and interactive healing spaces [18].  
Despite growing interest in healthcare acoustics more broadly, a significant gap persists in the literature concerning dental clinics specifically. While hospital acoustics are increasingly standardized and regulated, dental settings continue to lack clear guidelines or best practices for soundscape design. Moreover, few studies attempt to integrate acoustic optimization with sustainable or biophilic design practices tailored to dental environments [11; 19; 20; 21]. This review aims to systematically examine the characteristics and impact of soundscapes in dental environments and to propose integrative design strategies that align with both sustainable development and patient-centered care. Drawing on findings from acoustic engineering, environmental psychology, clinical dentistry, and healthcare architecture, this review addresses the urgent need to reimagine dental spaces as environments of holistic healing, where sound is not an incidental byproduct but a designed and therapeutic component of care.