| 1. Receiving an anesthetic injection in the mouth | Not at all | A little | A fair amount | Very much | Extreme |
| 2. Having a tooth drilled | Not at all | A little | A fair amount | Very much | Extreme |
| 3. Receiving root canal treatment | Not at all | A little | A fair amount | Very much | Extreme |
| 4. Having a tooth pulled | Not at all | A little | A fair amount | Very much | Extreme |
| 5. Having a wisdom tooth extracted | Not at all | A little | A fair amount | Very much | Extreme |
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