| Yes No |
Do you dislike the color of your teeth?
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Do you have spaces between your teeth that bother you?
|
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Do you have chips or uneven edges on your teeth?
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Do you feel that your your teeth are too long or too short?
|
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Do you have dark fillings that show when you smile?
|
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Do your gums show too much when you smile?
|
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Are your teeth crowded or crooked?
|
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Do you have existing crowns or dental work you consider "ugly"?
|
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Are you self-conscious of your teeth and/or smile?
|
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Has anyone (Friend, Family member, etc..) ever suggested that you should have something done with your teeth or smile?
|
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Do you avoid smiling when you have your picture taken?
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Would you like to improve your existing smile?
|
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Do you wish you had a "new smile"?
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