Dental Health Questionnaire – Pacific Palisades Dentistry - Smile Analysis
Your smile affects your self-image, and can greatly influence the quality of your interactions with others. Our Pacific Palisades Dentistry team knows that many people hold back from laughing or smiling because they are uncomfortable with their smile. The following dental health questionnaire is designed to honestly appraise your smile. It touches on all things dental such as swollen gums and crooked teeth. Go to a mirror, smile wide enough to see all of your teeth, and ask yourself the following questions:
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.
Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.