Gentle Dental Care
Scott D. Anderson, DDS
Creating Beautiful Smiles
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Contact
Call: 970.641.4200
215-383-6700 | Warminster, PA - 316 York Road
215-677-2022 | Philadelphia, PA - 10108 Bustleton Ave.
Warminster, PA - 316 York Road 18974
Philadelphia, PA - 10108 Bustleton Ave. 19116
Smile Analysis
Are any of your teeth yellow, stained or somewhat discolored?
*
Yes
No
Would you like your teeth to be whiter?
*
Yes
No
Do you have any gaps or spaces between your teeth?
*
Yes
No
Are any of your teeth turned, crooked, or uneven?
*
Yes
No
Are you missing any teeth?
*
Yes
No
Do you see any pitting or defects on the surfaces of your teeth?
*
Yes
No
Are the edges of any teeth worn down, chipped or uneven?
*
Yes
No
Do any of your teeth appear too small, short, large or long?
*
Yes
No
Do you have any prior dental work that appears unnatural?
*
Yes
No
Do you have any crowns or bridges that appear dark at the edge of your gums?
*
Yes
No
Do you have any gray, black or silver (mercury) fillings in your teeth?
*
Yes
No
Do you have a "gummy" smile (too much of your gums show when smiling)?
*
Yes
No
Are your gums red, sore, puffy, bleeding or receded?
*
Yes
No
Does the appearance of your smile inhibit you from laughing or smiling?
*
Yes
No
When being photographed, do you smile with your lips closed instead of flashing a full smile?
*
Yes
No
Are you self-conscious about your teeth or smile?
*
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 the questions above, there are often several alternatives to improve your teeth and smile. To receive a personalized response to your smile analysis, please complete the form below. You can have the smile you’ve always wanted! To schedule a
FREE, no obligation office consultation
, contact us today to schedule an appointment.
Questions & comments
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