Skip to main content
. 2018 Jul 18;2018:6078457. doi: 10.1155/2018/6078457

Table 2.

Orofacial pain therapy effectiveness questionnaire.

Name:
Age:
Sex:

No Questions Level
Not at all A little bit Moderately A lot

1 After the therapy, did you feel any improvement on the following functions?
 (a) Chewing
 (b) Speaking
 (c) Closing and Opening the mouth

2 After the therapy, did you feel that:
 (a) the intensity of your pain decrease?
 (b) the frequency of the occurrence of the pain decrease?
 (c) the pain decrease when you perform certain jaw movement?

3 After the therapy, were you able to perform the following activities as per usual?
 (a) Work activity
 (b) Social activity
 (c) Daily activity