Smile Analysis

Are any of your teeth yellow, stained or somewhat discolored? YesNo
Would you like your teeth to be whiter? YesNo
Do you have any gaps or spaces between your teeth? YesNo
Are any of your teeth turned, crooked, or uneven? YesNo
Are you missing any teeth? YesNo
Do you see any pitting or defects on the surfaces of your teeth? YesNo
Are the edges of any teeth worn down, chipped or uneven? YesNo
Do any of your teeth appear too small, short, large or long? YesNo
Do you have any prior dental work that appears unnatural? YesNo
Do you have any crowns or bridges that appear dark at the edge of your gums?YesNo
Do you have any gray, black or silver (mercury) fillings in your teeth? YesNo
Do you have a "gummy" smile (too much of your gums show when smiling)? YesNo
Are your gums red, sore, puffy, bleeding or receded? YesNo
Does the appearance of your smile inhibit you from laughing or smiling? YesNo
When being photographed, do you smile with your lips closed instead of flashing a full smile? YesNo
Are you self-conscious about your teeth or smile? YesNo
Would you like to change anything about the appearance of your teeth or smile? YesNo

You can have the smile you’ve always wanted! To schedule a FREE, no obligation office consultation, contact us today to schedule an appointment.