Simplified Anxiety Scale (SAS-3): Development, Psychosocial Justification, and Clinical Application in Patients with Orofacial Pain

Orofacial pain (OFP) and temporomandibular disorders (TMDs) are complex conditions whose chronicity and severity are strongly influenced by psychosocial factors, notably anxiety. The assessment of these factors in dental practice is hampered by the length of traditional instruments (e.g., GAD-7, HADS), creating a gap between clinical necessity and application feasibility. This article presents the development of the Simplified Anxiety Scale (SAS-3), a brief, three-item screening tool that assesses the affective, cognitive, and somatic domains of anxiety on a 5-point frequency scale (total score 0-12). The development methodology was based on a clinical-rational approach, with item selection from validated scales and the definition of proportional cutoff points to classify anxiety as mild, moderate, relevant, or severe. The SAS-3 is justified not only by its practicality but also by its psychosocial relevance, promoting an approach that considers the impact of adverse childhood experiences and gender inequalities in the manifestation of chronic pain. The scale was designed to be integrated into clinical protocols, facilitating decision-making, interdisciplinary referrals, and the humanization of care. Although formal psychometric validation is required, the SAS-3 represents a pragmatic advancement for incorporating the emotional dimension into orofacial pain management.