Dr Divito

Contact Us 480 990 1905

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TMJ Syndrome
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TMJ Questionnaire
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TMJ Questionnaire

Please answer the following questions and we will let you know if we think you should consult a TMJ expert.

Do you have ... in the ears?

Do you have pain in the jaw joints

Can you easily open your mouth wide enough to eat?

When you chew, do your joints

Do you have pain while chewing?

Does your bite feel different

Do your teeth hurt?

Are they sensitive to hot or cold?

Do you clench or grind your teeth at night?

Are you experiencing

Does your jaw get stuck open or closed?

Do bright lights bother you?

Other Symptoms

Name:

Email:

Telephone:

Please contact me.

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