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OMT Clinics Self-Assessment

This self-assessment questionnaire will help determine if myofunctional therapy is suitable for you. Answer the questions below to assess if our therapy could benefit your health.

Scoring Guide:

1-4 yes answers: Myofunctional therapy may be beneficial for you.

5-8 yes answers: Myofunctional therapy is likely to significantly improve your symptoms.

9+ yes answers: It is highly recommended to consult with our myofunctional therapists for a detailed evaluation.

Click the button below to start.

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Question 1 of 12

Do you experience difficulty in breathing through your nose during day or night?

A

YES

B

NO

Question 2 of 12

Do you use any aids for breathing during sleep, such as a CPAP machine or mouth guard?

A

YES

B

NO

Question 3 of 12

Has a healthcare professional ever diagnosed you with any breathing disorders, including obstructive sleep apnea?

A

YES

B

NO

Question 4 of 12

Were you told or treated for having a restricted lingual frenulum (tongue-tie) at any age?

A

YES

B

NO

Question 5 of 12

As a child, did you have habits like thumb sucking, extended use of a pacifier, or prolonged bottle feeding?

A

YES

B

NO

Question 6 of 12

Do you suffer from frequent headaches, neck pain, or facial pain?

A

YES

B

NO

Question 7 of 12

Have you noticed habitual teeth grinding or clenching, particularly during sleep?

A

YES

B

NO

Question 8 of 12

Do you often find yourself breathing through your mouth, especially during sleep?

A

YES

B

NO

Question 9 of 12

Have you had issues with large tonsils, frequent throat infections, or had an adenoidectomy?

A

YES

B

NO

Question 10 of 12

Do you have a history of allergies, particularly those affecting your nasal passages or airways?

A

YES

B

NO

Question 11 of 12

Have you undergone orthodontic treatments, especially those involving palate adjustments or braces?

A

YES

B

NO

Question 12 of 12

Do you feel your facial muscles are often tense or do you have difficulties with swallowing?

A

YES

B

NO

Confirm and Submit