Smile Evaluation

    A simple Evaluation to Help You Obtain the Smile You’ve Always Wanted


    Hold a mirror 12"–14" from your face. Smile to show your teeth. Take the time to observe your teeth carefully, and then answer the following questions:

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    Smile Evaluation

    A simple Evaluation to Help You Obtain the Smile You’ve Always Wanted


    Hold a mirror 12"–14" from your face. Smile to show your teeth. Take the time to observe your teeth carefully, and then answer the following questions:

    1. Do you like the appearance of your teeth and your smile? YesNo
    If not, explain

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    2. Are your teeth all in alignment (straight)? YesNo
    If not, explain

    image1

    3. Do you have spaces that you don’t like? YesNo
    If yes, explain

    image1

    4. Do you like the color of your teeth? YesNo
    If not, explain

    image1

    5. Do you like the shape of your teeth? YesNo
    If not, explain

    image1

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    Smile Evaluation

    A simple Evaluation to Help You Obtain the Smile You’ve Always Wanted


    Hold a mirror 12"–14" from your face. Smile to show your teeth. Take the time to observe your teeth carefully, and then answer the following questions:

    6. Are your teeth…
    Chipped YesNo
    Protruding YesNo
    HiddenYesNo
    If yes, explain

    image1

    7. Are your teeth wearing on the biting surfaces? YesNo
    If yes, explain

    image1

    8. Are there old fillings or dental work you don’t like looking at? YesNo
    If yes, explain

    image1

    9. What would you like to change the most in the appearance of your teeth?

    image1

    10. How would you like your teeth to look?

    image1

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