Free Smile Analysis Name* First Last Phone*Email* How many teeth show in your smile?Are you happy with your smile? Yes No Describe the color of your teeth: very white off white yellow dark yellow grey Are your teeth evenly colored? Yes No Are there any defects on your front teeth? Yes No Any fillings or crowns showing? Yes No Are your teeth crowded? Yes No Do you have spaces or gaps between your teeth? Yes No How many?Do your gums show when you smile? Yes No Do you like the amount of gums that show when you smile? Yes No Further comments about your smile:
