Cosmetic Dentist - Weatherford
114 W. Columbia Street
Weatherford, TX 76086
(817) 594-3806
| Do you get an unusual amount of headaches? | Y |
N |
| Do you have a grating, clicking or popping sound in either or both jaw joints, when you chew or open and close your mouth? | Y |
N |
| Do you have pain or soreness in any of the following areas: jaw joints, upper jaw, lower jaw, side of neck, back of head, forehead, behind the eyes or temples? | Y |
N |
| Do you have sensations of stuffiness, pressure or blockage in your ears? Is there excessive wax buildup? | Y |
N |
| Do you ever have ringing, roaring, hissing or buzzing sounds in your ears? | Y |
N |
| Do you ever feel dizzy or faint? | Y |
N |
| Do your fingers, hands or arms sometimes tingle or go numb? | Y |
N |
| Are you tired
all the time, fatigue easily or consider yourself chronically fatigued? |
Y |
N |
| Are there imprints of your teeth on the sides of your tongue? | Y |
N |
| Does your tongue go between your teeth when you swallow? | Y |
N |
| Do you have difficulty in chewing your food? | Y |
N |
| Do you have any missing back teeth? | Y |
N |
| Do you clench your teeth during the day or at night? | Y |
N |
| Do you grind your teeth at night? (Ask your family.) | Y |
N |
| Do you ever awaken with a headache? | Y |
N |
| Have you ever had a whiplash injury? | Y |
N |
| Have you ever experienced a blow to the chin, face or head? | Y |
N |
| Have you reached the point where drugs no longer relieve your symptoms? | Y |
N |
| Does chewing gum worsen your symptoms? | Y |
N |
| Is it painful to stick your "pinky" fingers into your ears with your mouth open wide and then close your mouth while pressing forward with your "pinky" fingers? | Y |
N |
| Does your
jaw slide to the left or right when you open wide? (Look in a mirror.) |
Y |
N |
| Are you unable to insert your first three fingers vertically into your mouth when it is open wide? | Y |
N |
| Is your face crooked and not symmetrical? | Y |
N |
Place your fingers in front of your ears on the joint and apply pressure.