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:

    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

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

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

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

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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

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

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

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

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    10. How would you like your teeth to look?

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