Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 2 make seem activities Tell Us About Your Head Pain Many people with jaw disorders experience pain or pressure in their head, face, or temples. These symptoms may or may not feel like a traditional headache. Please tell us about your experience. Do you experience head pain?YesNoOccasionallyHow would you describe your head pain?Dull or achingPressure or tightnessThrobbing or pulsatingSharp or stabbingBurningSqueezing or band-likeTender to touchHeavy feelingComes and goesConstantWhere do you usually feel your head pain?ForeheadTemplesBehind the eyesTop of the headBack of the headBase of the skullEntire headFaceOtherWhich side is affected?RightLeftBoth sidesVariesHow often do you experience headaches?Every daySeveral times each weekOnce a weekSeveral times a monthOccasionallyApproximately how long do your headaches last?Less than 30 minutes30 minutes–2 hours2–6 hoursMost of the dayAll dayMore than one dayWhen do they usually occur?Upon wakingMid-morningAfternoonEveningDuring the nightRandomlyWhat activities seem to make your headaches worse?ChewingTalking for long periodsStressComputer workReadingDrivingExerciseBright lightsLoud noisesWhat helps relieve your headaches?RestIceHeatMassageMedicationSleepStretchingNothing seems to helpOtherDo your headaches ever include any of the following?NauseaSensitivity to lightSensitivity to soundDizzinessBlurred visionRinging in your earsNone of the aboveDo your headaches ever wake you from sleep?YesNoHave your headaches changed over time?They are becoming more frequent.They are becoming more severe.They have stayed about the same.They have improved.Please Rate Your Headaches/HeadpainRate 1 out of 10Rate 2 out of 10Rate 3 out of 10Rate 4 out of 10Rate 5 out of 10Rate 6 out of 10Rate 7 out of 10Rate 8 out of 10Rate 9 out of 10Rate 10 out of 10NextTell Us About Your Jaw Your jaw joint and the muscles that control it are used hundreds of times every day for eating, talking, yawning, and smiling. These questions help us understand how your jaw symptoms affect your daily life. Do you experience jaw pain?YesNoOccasionallyWhich side is affected? RightLeftBoth sidesVariesWhere do you usually feel your jaw pain?In front of the earJaw jointCheekLower jawUpper jawTempleUnder the jawOtherHow would you describe your jaw pain? Dull or achingSharp or stabbingThrobbingBurningPressure or tightnessSorenessTender to touchCrampingFatigue or tirednessComes and goesConstantOtherWhen do you notice your jaw pain?Upon wakingWhile eatingAfter eatingTalking for long periodsYawningDuring stressful situationsAt the end of the dayRandomlyWhat activities seem to make your headaches worse?ChewingOpening wideTalkingYawningClenchingGrindingStressSingingExercisingOtherWhat helps relieve your headaches? RestHeatIceMassageStretchingMedicationSoft foodsNightguardNothing seems to helpOtherHave you noticed any of the following?ClickingPoppingGrinding noisesLocking openLocking closedJaw catches before openingJaw feels stuckJaw shifts to one sideDifficulty opening widePain with chewingJaw fatigueBite feels differentNone of the aboveDoes your jaw ever lock?NoYes, occasionallyYes, frequentlyApproximately how wide can you comfortably open your mouth?Less than two fingersTwo fingersThree fingersMore than three fingersI’m not sureHow does your jaw pain affect your daily life?I avoid certain foods.I cut food into smaller pieces.I chew on one side only.Talking for long periods causes discomfort.I avoid yawning because it hurts.I have difficulty enjoying meals.My jaw pain affects my sleep.My jaw pain affects my work.My jaw pain affects my mood.Please Rate Your Jaw DiscomfortRate 1 out of 10Rate 2 out of 10Rate 3 out of 10Rate 4 out of 10Rate 5 out of 10Rate 6 out of 10Rate 7 out of 10Rate 8 out of 10Rate 9 out of 10Rate 10 out of 10PreviousSubmit