Pain intensity |
1. Do you now have pain? |
2. Do you now have pain from the molars? |
3. Do you now have pain from the incisors? |
4. Do you now have pain from the upper jaw? |
5. Do you now have pain from the palate? |
6. Do you now have pain from the tongue? |
Discomfort |
7. Do you experience tensions in your upper jaw? |
8. Do you experience tensions in your teeth? |
9. Do you experience soreness from the appliance? |
Analgesic consumption |
10. Have you used analgesics for pain from your jaws, teeth, or face? |
If yes, what kind of analgesic and dosage did you use? |
Jaw function impairment |
If you now have pain or discomfort in your teeth and jaws, how much does that affect |
11. Your leisure time |
12. Your speech |
13. Your ability to take a big bite |
14. Your ability to chew hard food |
15. Your ability to chew soft food |
16. Your schoolwork |
17. Drinking |
18. Laughing |
19. Yawning |
20. Swallowing |
Eating means taking a bite, chewing, and swallowing. How difficult is it for you to eat |
21. Crisp bread |
22. Meat |
23. Raw carrots |
24. Roll |
25. Peanuts |
26. Apples |
27. Cake |