TMJ Disorder Questionnaire

TMJ Disorder Questionnaire

TMJ Disorder Questionnaire

Preparing for Your TMD (TMJ) Consultation

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A misaligned jaw can affect your entire body or a specific part of it. The slightest imbalance in your temporomandibular joint (TMJ) could result in headaches, dizziness, nausea, and premature wearing of your teeth.

In many instances, it can contribute to poor body posture, decreased strength and flexibility.

Take this Pain Test to learn more. Submit your answers then we will respond shortly with our recommendations.

Your first appointment with Dr. Westersund could be the first step to life lasting dental health.


To make the consultation more valuable for you and more productive for us, here are a few tips to prepare ahead of time:


1. Please fill out the New Patient forms on Here are the links:

2. Please fill out the TMJ questionnaire form on Here is the link:

3. Watch these two YouTube videos to give you some background about what we may be talking about at your appointment:

4. Give yourself time. Depending on the severity of your problem, this appointment may take longer than planned. We will make all attempts to do what is needed in your first appointment but plan for at least 2 hours. If you have not filled out your forms online, please come into the office 20 – 30 minutes prior to your appointment to fill out the forms at our office.

5. Wear form fitting clothing. Please avoid wearing bulky clothing as this prevents us from being able to assess posture.

6. Wear footwear that you can take off. Yes, we will be looking at your feet and ankles. People with improper arches have extra structural strain to their body. We document this with photographs so have footwear that can be taken off easily.

7. If you wear make-up then bring your touch up products. We are examining the head and neck and make-up can be smudged. If you require touching up your make-up then bring what you need.

8. Do you have long hair? If so we have hair elastics available to pull your hair from around your ears and neck. You can also bring your own products if that is better for you.

9. Bring your significant other. If you need to discuss your treatment or have another set of ears listening to your treatment options, by all means bring whomever you need with you. This may make choosing treatments more efficient for you. We certainly will accommodate whomever you choose to bring and listen in.

10. Bring in any dental appliance you are using now to help you deal with your TMD (TMJ) problems. “Nightguards” or “Splints” you use can be brought so we can see what therapy has been tried in the past.


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