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Table 3 Questionnaire for assessing TMD

From: Missing upper incisors: a retrospective study of orthodontic space closure versus implant

Severity of occurrence 0 1 2 3
1. Do you have difficulty in opening your mouth?     
2. Do you have difficulty in moving or using your jaw?     
3. Do you have tenderness or muscular pain when chewing?     
4. Do you have frequent headaches?     
5. Do you have neck aches or shoulder pain?     
6. Do you have pain in or about the ears?     
7. Are you aware of noises in the jaw joints?     
8. Do you consider your bite “normal”?     
9. Do you use only one side of your mouth when chewing?     
10. Do you have morning facial pain?