TMJ Questionnaire

Please fill out this brief questionnaire to help determine if you might be suffering from TMJ

"*" indicates required fields

Name*
Do you have difficulty, pain or both when opening your mouth (eg. When yawning)
Does your jaw get stuck, get locked, or go out?
Do you have difficulty, pain or both when chewing, talking, or using your jaws?
Are you aware of noises in the jaw joints?
Do your jaws feel regularly stiff, tight, or tired?
Do you have pain in or near your ears, temples, or cheeks?
Do you have frequent headaches, neck aches, or tooth aches?
Have you had a recent injury to your head, neck, or jaw?
Have you been aware of any changes to your bite?
Have you been previously treated for unexplained facial pain or a jaw joint problem?
This field is for validation purposes and should be left unchanged.