Smile Analysis

Patient Name*
First Last
Email
What do you like about your smile?
What do you not like about your smile?
What do you have concerns about? Check all that apply.
- Spacing of Teeth
- Position of Teeth (Crowding or Crooked)
- Symmetry of Teeth
- Show Too Much Gum
- Upper Teeth Overlap Lower Teeth (Overbite)
- Upper Teeth Sit Inside the Lower Teeth (Crossbite)
- Upper and Lower Teeth Do Not Meet (Openbite)
Comments/Questions:
Comments
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