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A Simple Test To Solve Your Smile!

Smile and look carefully at your teeth, then answer the following questions. Once finished, please click 'Submit'. We will contact you to discuss the questionnaire in person.

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1. What would you like to change the most in the appearance of your teeth?
   
2. How would you like your teeth to look?
   
3. Do you like the look of your teeth and your smile?   Yes    No
   If not, explain:
   
4. Do you have spaces between your teeth that you dislike?   Yes    No
   If yes, explain:
   
5. Do you like the color of your teeth?   Yes    No
   If not, explain:
   
6. Are your teeth aligned (straight)?   Yes    No
   If not, explain:
   
7. Do you like the shape of your teeth?   Yes    No
   If not, explain:
   
8. Do you like the way your teeth come together?   Yes    No
   If not, explain:
   
9. Are there any old fillings or dental work that you don't like looking at?   Yes    No
   If yes, explain:
   
10. Are your teeth...
      Chipped
      Protruding
      Hidden