Physical Therapy Associates in Elizabethtown, KY

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Jaw Functional Limitation Scale - 20

For each of the items below, please indicate the level of limitation during the last month. If the activity has been completely avoided because it is too difficult, then circle ‘10'. If you avoid an activity for reasons other than pain or difficulty, leave the item blank.

1. Chew tough food

2. Chew hard bread

3. Chew chicken (e.g., prepared in oven)

4. Chew crackers

5. Chew soft food (e.g., macaroni, canned or soft fruits, cooked vegetables, fish)

6. Eat soft food requiring no chewing (e.g., mashed potatoes, apple sauce, pudding, pureed food)

7. Open wide enough to bite from a whole apple

8. Open wide enough to bite into a sandwich

9. Open wide enough to talk

10. Open wide enough to drink from a cup

11. Swallow

12. Yawn

13. Talk

14. Sing

15. Putting on a happy face

16. Putting on a angry face

17. Frown

18. Kiss

19. Smile

20. Laugh

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Brandenburg Jaw, TMJ Forms

Jaw Functional Limitation Scale - 20

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