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Smile Analysis

I wish the color of my teeth were whiter.

I notice gaps between my teeth

I think some of my teeth are too small

I think some of my teeth are too big

I have old fillings/previous treatment that no longer satisfies me.

I wish my teeth were straighter.

I think my smile shows too much space between my teeth.

I sometimes hesitate to smile because I am not totally pleased with my smile.

Concerns about fees

Concerns about the end result

Concerns about treatment

Smoking cessation

Nutrition

Other Concerns

Other:

How much do you value dental appearance?

How much do you value dental health?

My main dental concern is…

Name

Serving patients in: Toledo, Sylvania, Maumee, Perrysburg, SE Michigan, Bedford, Temperance, and beyond.