Smile Analysis

A person's smile has the ability to impact their self esteem and the quality of social interactions with other people. If you are wondering how much your smile affects you, please fill out the following form. If you have any questions along the way, don't hesitate to contact us at 281-492-6064. We look forward to hearing from you.

Do you have any yellow, stained, or discolored teeth?

Do you want to have whiter teeth?

Are there unnatural gaps or spaces between any of your teeth?

Do you have any teeth that are out of place, uneven or crooked?

Do you have any teeth that are missing?

Have you noticed any troublesome pits / defects on your teeth?

Do you have any chipped, worn down, or uneven edges on any teeth?

Are any of your teeth misshaped; too small, large, long, short?

Have you previously had dental work that seems unnatural?

Do you have crowns and/or bridges that are discolored or dark?

Are there any amalgam, silver fillings in your teeth?

When you smile, do you think too much of your gums show?

Have any of your gums receded, gotten red, sore, puffy or bleeding?

Do you find it difficult to laugh because of the appearance of your teeth?

Do you smile with your lips closed or do you give a full smile?

Does your smile make you feel self conscious or uncomfortable?

Is there anything about your smile that you wish you could change?

Thank you for answering the questions above. To finish the process and receive a custom, smile analysis response from our office, please finish filling out the form below and we will be in touch soon. The analysis results will be provided in a FREE of charge, in-office consultation. We look forward to meeting you and will be in touch as soon as possible. You may call us at 281-492-6064 with any questions.