EN
21
Ques onnaire to Monitor Your Personal Success
To monitor the e
ff
ec veness of your b2go, we have developed the following ques onnaire for you. Please
rate the symptoms that apply to you before you
fi
rst use your b2go and then a er a few nights.
Ques onnaire Before
Ra ng scale 0 to 10 (0 = not applicable, 10 = very strong)
Symptoms A er Ge ng Up
Before
Headaches
Tinnitus
Impaired vision
Aching facial muscles
Tiredness in the jaw region
S
ff
ness of movement of the jaw
Rubbing sounds from the mandibular
joint
Clicking from the mandibular joint
Aching mandibular joint
Lower jaw blocked
Shoulder pain
Neck pain
Back pain
Fa gue / redness
Other symptom that you ascribe to
teeth grinding:
