-
Have you noticed a change in your bite?
- Do you feel like your teeth hit first on the right or left side?
- Do you hit more on the front teeth or more on the back teeth?
-
Are you aware of any of the following:
- Popping/Clicking?
- Grinding?
- Noise in the Jaw Joints?
-
Do you have difficulty or pain:
- Opening wide?
- Chewing?
-
When you wake up, do your jaw joints or muscles feel tight or sore?
-
Do you snore at night?
-
After eating, do your jaw joints or muscles feel:
- Stiff?
- Tight?
- Tired?
-
Do you grind or clench your teeth:
- At night?
- During the day?
-
Do your gums bleed after:
- Brushing?
- Flossing?
-
Do you experience pain in your:
- Jaw?
- Face?
- Neck?
- Shoulder and/or Arms?
-
Do you get:
- Headaches?
- Migraines?
-
If Yes, what time of day do they occur:
- Morning?
- Afternoon?
- Night?
- Anytime?
-
How many headaches (H) and/or migraines (M) in:
- each week? ______ (H)/ ______ (M)
- each month? ______ (H)/ ______ (M)
-
What medications do you take to relieve them? _____________
How long do they last without medication? _____________
-
Do you have any
- Ringing?
- Fullness in your ears?
-
Do you ever get
- Dizzy?
- Sea sick?
-
Do you ever feel
- Anxiety?
- Stressed?
-
How would you rate your stress level:
- Mild?
- Moderate?
- Severe?
-
Have you had braces or orthodontic treatment?
-
If Yes, when did you finish your treatment? ______________
-
If you answered yes to 2 or more of these questions, you may be suffering from TMJ. Call us today at 855-865-3627 to schedule a free consultation.
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