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

If you answered YES to ANY of the questions above, there are often several alternatives to improve your teeth and smile. To receive a personalized response to your smile analysis, please complete the form below. *
You can have the smile you’ve always wanted! To schedule a FREE, no obligation office consultation, contact us today to schedule an appointment.