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Smile Analysis

Your smile affects your self-image, and can greatly influence the quality of your interactions with others. Many people hold back from laughing or smiling because they are uncomfortable with their smile. The following questions are designed to honestly appraise your smile. Go to a mirror, smile as wide as you can, and ask yourself the following questions:

Does the appearance of your smile inhibit you from laughing or smiling?

Yes No

Are you missing any teeth?

Yes No

When being photographed, do you smile with your lips closed instead of flashing a full smile?

Yes No

Are you having difficulty chewing because you are missing teeth?

Yes No

Are your teeth loose or shifting?

Yes No

Do you have a loose denture, you have a hard time wearing because it won't stay in place when you eat or talk?

Yes No

Are you self-conscious about your teeth or smile?

Yes No

Are your gums red, sore, puffy, bleeding or receded?

Yes No

Do you have bad breath you just can't get rid of no matter how much you brush?

Yes No

Do you have a bad taste in your mouth?

Yes No

Do your teeth seem longer then other peoples?

Yes No

Do your gums bleed when you brush or floss?

Yes No

Are your teeth sensitive to hot and cold?

Yes No

Do you have chronic dry mouth?

Yes No

Do you have a "gummy" smile (too much of your gums show when smiling)?

Yes No

Would you like to change anything about the appearance of your teeth or smile?

Yes No

If you answered YES to ANY of these questions, there are often several alternatives to improve your teeth and smile. To receive a personalized response to your smile analysis, please complete the following form.

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

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