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Oral Facial Symptoms Score - Whole Health Dental Center

Oral Facial Symptoms Score

Do you, or your child, have the following signs and symptoms? Oral-facial Physical Therapy (myo-functional therapy) may be an effective and low cost solution.

To find out, please check off each line even if only one condition on that line applies. Each line item is equal to one score point. Please add up your total score, by adding one point for each line item that was checked. When completed,
please email Dr. Liao or contact us.

Check Each line item that relates to you, your child, or anyone in your family:

____ Facial Symmetry: higher on one eye, one ear, one corner of mouth

____ Deviation: nose, chin not centered, lower jaw can’t rack straight during opening-closing

____ Asthma, allergies, stuffy nose, runny nose, bags under eyes, mouth breathing

____ Finger or thumb sucking, lip biting, nail biting, pencil chewing, munch on hair or necklace

____ Lips apart, chapped, cracked, pencil thin, flat or short upper lip

____ Trouble swallowing pills, tongue thrusting, tongue chewing/cushioning

____ Resting Tongue Posture now: floor of mouth, against front teeth, or between teeth

____ Tongue tie: cannot touch back of upper front teeth with mouth wide open

____ Tooth print on tongue’ sides, gap(s) between upper or lower front teeth

____ Speech: mumbling, slurring, unclear pronunciation, poor voice projection

____ Sleep: restless, blankets on the floor, drooling, teeth grinding, snoring, sleep apnea

____ Eating with mouth open, noisy eating, needing to wash food down with drink

____ Peculiar mannerisms in eating, drinking, or speaking, chewing blanket or clothing

____ Posture: head tile, forward neck, one shoulder higher, slouching, scoliosis

____ Pain: head, neck, face, ear, throat, sinus, teeth, upper back

____ ADD/ADHD, Down Syndrome, learning disabilities, inability to focus, can’t stay focused

____ Teeth: crowded, crooked, cross bite, open bite, closed bite, buck teeth,

____ Jaws: narrow, deep overbite, weak chin, long chin,

____ Clicking jaw joints, ear ringing, hearing loss, poor school performance, frequent colds

____ Orthodontic treatment, extraction for braces, orthodontic relapse

____ Low self-confidence, -esteem, withdrawn, tired during the day, depressed, not thriving