1. Headaches or Jaw aches?
Yes
No

2. Worn, chipped or cracked teeth?
Yes
No

3. Neck, shoulder or back pain?
Yes
No

4. Cracked or broken dental restorations?
Yes
No

5. Pain or soreness around the jaw joints?
Yes
No

6. Facial pain?
Yes
No

7. Unexplained loose teeth?
Yes
No

8. Congestion, stuffiness or pain in the ears?
Yes
No

9. Clicking, popping or grating sounds in the jaw joint?
Yes
No

10. Limited movement or locking jaw?
Yes
No

Score =

If your score is above 30% you may be suffering from TMJ and we may be able to help you.