Total your score for the following questions to find out.

• 4-10      Low Fear
• 11-15    Moderate Fear
• 16-20    Extreme Fear

If you had to go to the dentist tomorrow, how would you feel about it?

1. I would look forward to it as a reasonably enjoyable experience
2. I would be a little uneasy about it
3. I would be very frightened of what the dentist might do
4. I wouldn't care one way or the other
5. I would be afraid that it would be unpleasant and painful

When you are waiting in the dentist's office for your turn in the chair, how do you feel?

1. Relaxed
2. A little uneasy
3. Tense
4. Anxious
5. So anxious, that I sometimes break out in a sweat, or almost feel physically sick

When you are in the dentist's chair waiting while he/she gets his/her drill ready to begin working on your teeth, how do you feel?

1. Relaxed
2. A little uneasy
3. Tense
4. Anxious
5. So anxious, that I sometimes break out in a sweat, or almost feel physically sick

You are in the dentist's chair to have your teeth cleaned. While you are waiting, the dentist is getting out the instruments which he/she will use to scrape your teeth around the gums. How do you feel?

1. Relaxed
2. A little uneasy
3. Tense
4. Anxious
5. So anxious, that I sometimes break out in a sweat, or almost feel physically sick