Patient Smile Assessment


Do you like to smile wide enough to show your teeth?              Y or N

Are you happy with the way your teeth look?                             Y or N

  Are you satisfied with the whiteness of your teeth?                   Y or N 

Are you missing teeth?                                                                   Y or N

   Are you interested in improving the appearance of your teeth?  Y or N

Do your teeth or gums hurt?                                                         Y or N

Are you anxious or fearful of treatment?                                     Y or N

Are you interested in cosmetic dentistry?                                   Y or N

Do you like the look of your crowns or fillings?                          Y or N


Is there any dental treatment that you would like to learn more about?
                                 
   Call us at 303-526-9155 so that we can do a personal evaluation so that you can have a lifetime of healthy smiles.