Craniofacial Pain/TMJ? Take the Test

Do you have Craniofacial Pain/TMJ? Take the Test

If any of the following symptoms affect your daily life or you are taking regular pain medication or sleeping aids, you may be suffering from TMD and should be evaluated by a dentist trained in diagnosing and treating these disorders.

Do you have TMJ/TMD?

Name*
First Last
Do you or your child have any of the following symptoms? (check all that apply)*
- Headaches - recurring or chronic
- Earache or ear symptoms of stuffiness or ringing
- Neck Pain or Stiffness
- Facial Pain
- Jaw joint sounds - clicking, popping or grating
- Limited ability to open or close mouth
- Jaw locking (opened or closed)
- Sensitive, loose or worn down teeth
- Pain or soreness in the TM joints
- Dizziness or Pain or difficulty chewing or swallowing
- Pain behind the eyes
- Extreme sensitivity to light
- ADHD
- Bed wetting
Email*
Phone*
City*
State*

Patients

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