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TMJ Questionnaire­­

Please give yourself one point for every YES answer.



Do you have pain in your jaw joint?                                         Yes________               No________



Do you have limited mouth opening?                                     Yes________               No________



Do you have fullness in your ears?                                           Yes________               No________



Do you have ringing in your ears (tinnitus)?                        Yes________              No________



Do you have hearing loss?                                                             Yes________              No________



Do you have flat/worn teeth from grinding?                       Yes________              No________ 



Do you have noise in your jaw joint when you open?     Yes________              No________



Do you have headaches or migraines?                                   Yes________              No________



Do you have neck pain?                                                                  Yes________                No________



Do you have poor posture?                                                          Yes________               No________



What's your total?                                             Total________ 

If you have a total of 4 or more Points OR any one of these symptoms have impacted your quality of life on a daily basis,

please reach out to our office for help.  We look forward to meeting you!

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