## 3 Results
### Sustainability and Biophilic Integration  
The integration of sustainability and biophilic design in dental settings reflects a growing shift toward holistic and patient-centered care that acknowledges both environmental responsibility and psychological well-being [78]. Biophilic design, defined as the incorporation of nature-inspired elements into architectural planning, has demonstrated measurable impacts on patient outcomes [79]. Research has shown that incorporating biophilic elements such as green walls, indoor plants, natural wood finishes, and organic textures can significantly reduce patient anxiety in healthcare environments [15]. These design features have also been associated with higher levels of user satisfaction and enhanced physiological comfort, supporting both psychological restoration and sensory well-being [79]. Evidence indicates that even modest plant-based interventions, such as dish gardens, can lead to measurable improvements in neuropsychological outcomes among pediatric patients and patients in psychotherapy offices, supporting their integration into dental operatories and waiting rooms too [53]. In addition to visual biophilia, natural soundscapes, such as birdsong or flowing water, can mask mechanical noise and reduce physiological stress. Studies by [PERSON] & [PERSON] (2018), [PERSON] (2020), and [PERSON] (2020) confirm the anxiolytic effects of these sounds in healthcare settings, promoting calmness and enhancing cognitive clarity [55; 57; 63]. These findings justify the integration of nature-inspired audio environments in reception and treatment zones of dental clinics.  
Furthermore, designing for sustainability extends beyond aesthetics. Environmentally friendly material choices, such as bamboo wall panels, low-VOC (volatile organic compound) paints, and rubber flooring, enhance indoor air quality and support compliance with LEED and WELL Building Standards [13; 27]. Fenestration strategies that maximize daylight also reduce energy consumption while contributing to mood regulation and circadian alignment [65; 66; 80]. Research highlights that transitional areas such as corridors and lobbies are critical zones where patient stress often peaks, underlining the importance of targeted design interventions in these spaces [8; 81]. Here, biophilic elements serve not only as visual reprieve but as sensory anchors that aid orientation and reduce anxiety, especially for neurodivergent individuals. Incorporating acoustic panels made from recycled fibers, green wall systems, and multisensory zoning strengthens the link between comfort and sustainability [10; 65; 66; 80]. Importantly, as highlighted in the Routledge Handbook of High-Performance Workplaces (2023) and supported by [PERSON] (2024), acoustic performance and environmental sustainability are not competing priorities but are synergistic goals [82]. Acoustic comfort reduces cognitive load and supports well-being, while sustainable materials and design layouts improve long-term health and operational efficiency [26; 81; 82].  
In this study, based on the WELL Building Standard (v1 with May 2016 Addenda, [[https://standard.wellcertified.com/well](https://standard.wellcertified.com/well)]([https://standard.wellcertified.com/well](https://standard.wellcertified.com/well)), accessed on 10 May 2025), we present a list of relevant WELL features that intersect with our themes of soundscapes, patient well-being, environmental sustainability, and dental settings (Table 2).  
In summary, the convergence of biophilic and sustainable architectural strategies in dental settings contributes not only to reduced stress and better care experiences but also supports broader goals of resource efficiency, equity, and environmental responsibility [78; 82; 83; 84]. These innovations redefine the dental office as a healing space, actively designed to promote calm, resilience, and ecological stewardship.