Get Tmj Questionnaire - Nebraska Institute Of Comprehensive Dentistry - Smilesonline

Filling out the TMJ Questionnaire is an essential step in addressing your temporomandibular joint issues. This guide will walk you through each section of the form, ensuring you provide the necessary information accurately and efficiently.

Follow the steps to complete the TMJ Questionnaire with ease.

1. Press the ‘Get Form’ button to access and open the TMJ Questionnaire in the online form editor.
2. Begin by entering your name and the date at the top of the form. Specify your age to ensure accurate processing.
3. Indicate how you were referred to this questionnaire by filling out the 'Referred By' section.
4. In the section that asks which symptoms you experience, check all boxes that apply, including headaches, neck pain, jaw pain, ear pain, and facial pain. If you have other symptoms, specify them in the provided space.
5. Identify which side of your body experiences pain by selecting which option applies: both, right, or left.
6. Describe the duration of your pain in the designated field, and indicate whether the pain is constant.
7. Characterize the pain by selecting its quality — aching, burning, stabbing, or other. Fill out details in the specified area if needed.
8. Indicate when the pain is most intense by checking all applicable times: morning, afternoon, evening, or night.
9. If you have experienced any injuries or trauma to your jaw, head, or neck, indicate this by checking the appropriate boxes.
10. Provide details on what alleviates your pain and what exacerbates it in the spaces provided.
11. List any medications you are currently taking or have previously taken for your pain, including the medication name, dosage, and frequency.
12. Answer yes or no to the questions about discomfort while chewing and opening your mouth wide.
13. Specify which side of your jaw makes clicking or popping noises and provide details about any other jaw noises.
14. Indicate if your jaw has ever locked (open or closed) and provide relevant dates.
15. Mention if your jaw has slipped out of place and if you have noticed any changes in your bite or teeth alignment.
16. Indicate any changes in your profile or asymmetry noticed in your jaw.
17. Confirm whether your teeth are sore or sensitive and whether you clench your teeth during the day or night.
18. Indicate if you have ear problems and any difficulties with swallowing.
19. List any lumps observed in your face, neck, or throat.
20. Discuss any prior treatments for TMJ you have undergone, specifying any results.
21. Provide a brief description of your understanding of your problems in the designated area.
22. Finally, specify where you would like reports sent, and ensure you sign and date the document to confirm accuracy and consent.

Complete your TMJ Questionnaire online today to take the first step toward better dental health.