Answer the following 10 questions, then enter your e-mail address and click the submit button below. We will e-mail your free analysis within one business day.
We do not share e-mail addresses or patient information with anyone.
Privacy Policy
1) How often do you experience headaches - including migraines?
never Relief is available, but it takes someone with special training and experience.
sometimes
frequently
always
2) Have you experienced, or been told you clench or grind your teeth?
never
sometimes
frequently
always
3) Do you ever experience pain or tenderness in your facial area?
never
sometimes
frequently
always
4) Ever experience popping/clicking when opening/closing your mouth?
never
sometimes
frequently
always
5) Does chewing or talking cause soreness, pain or fatigue in your jaw?
never
sometimes
frequently
always
6) Do you ever experience unexplained ear pain or ringing sounds?
never
sometimes
frequently
always
7) Do you have neck or shoulder pain from an injury or auto accident?
never
sometimes
frequently
always
8) Do you (or been told that you) have receding gum lines?
never
sometimes
frequently
always
9) Is it difficult to find a comfortable bite or position for your mouth?
never
sometimes
frequently
always
10) Do you feel that you have limited mouth opening or movement?
never
sometimes
frequently
always
Please enter your E-mail Address:
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