Considering Botox Therapy

1. Do you wake up in the morning with jaw pain or your teeth clenched?

Never Maybe once a week About 2-3 times in a week Almost daily

2. Do your teeth hurt when you wake up in the morning?

Never Once a week or less At least a couple of times a week More often than not

3. Do you wake up with headaches in the morning?

Not at all Maybe once a week or less At least a couple of times a week Three days a week or more

4. Do your jaw muscles get “tired” while eating foods that require some hard chewing like a piece of steak or a bagel?

Rarely Occasionally Very often I’ve given up certain kinds of food because of this

5. Do you find yourself gritting your teeth during the day?

Not aware Every once in a while Depends on my stress level I do it throughout the day at work

6. Do you wake up with a dry mouth?

Never Rarely Sometimes Often

7. Do you keep breaking or chipping your molars (the back teeth)?

Not very often I have a few of my back teeth capped because of this Most of my molars are capped I keep breaking the crowns on my back teeth