TMJ Patient History Form
Jaw pain while chewing? Injury to head or jaw? Jaw pain upon opening wide? History of jaw locking opened or closed? Ear pain? Dizziness? Ringing in ears? Fainting spells? Grating noises in ears? Nausea? Feel or hear “clicking” or “popping” in jaw joint? Grinding/Clenching at night? Family history of jaw (TMJ) problems? ................
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