Background: Different dental procedures have different levels of anxiety, and the tooth extraction is in the top list of most frightening dental procedures. This anxiety should carefully managed physically and psychologically. Although there are several scales available to measure anxiety from dental treatment, a scale for measuring anxiety related to tooth extraction is still absent. The aim of the study was to develop a

new scale; the tooth extraction anxiety (TEA) scale; that is specifically measure anxiety in patients undergoing tooth extraction.

Materials and Methods: Two hundred and ninety two patients who presented for simple tooth extraction were recruited from two specialized dental centers in Mosul, Iraq. Each participant completed two self-administrated questionnaires; The Short version of Dental anxiety inventory (s-DAI) and the TEA scale. Moreover, Candidates asked to rate the amount of their anxiety toward tooth extraction on 11- point Numeric Rating Scale (NRS).

Results: Cronbach’s α for the present sample was 0.84 and all items of the scale are relevant (Cronbach’s α values if any item deleted ranged between 0.811- 0.846). Correlations with the s-DAI and the NRS were 0.44, P<0.01 and 0.48, P<0.01 respectively. The results indicated that the TEA scale has good reliability and acceptable validity.

Conclusion: This study developed and validated the TEA scale. It is easy to administer in general dental practices.