Smile Analysis

Answer the following questions below, then click "Submit".

When I see a picture of myself, the first thing I notice about my smile is:
 
Something I often notice about other smiles I consider attractive is:
 

General Questions   Please check the statements below you agree with:

I wish the color of my teeth were whiter.
I wish I had a broader smile.
I think some of my teeth are too small.
I think some of my teeth are too large.
I wish my teeth were straighter.
I think my gums show too much when I smile.
I think my smile shows too much space between some of my teeth.
Because I am not totally pleased with my smile, I sometimes hesitate to smile.
I have often wished I could change some of the features of my smile.
I feel as though I don't really know all of the options available for enhancing my smile.
Concerns over what the end result might look like, have been a factor in my not having cosmetic dentistry in my own mouth.
Concerns over fees have prevented me from taking advantage of some of the available options to enhance my smile.
I feel as though I could do a better job protecting the health of my teeth and gums, and therefore, the longevity of my own smile.

How do you rate your smile on a scale of 1-10, with 10 being the best smile?
1 2 3 4 5 6 7 8 9 10
 
Is it time to talk to you about enhancing your smile?
    
Yes    No

     

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Some of our procedures: Dental Implants | Teeth Whitening | Root Canals | Smile Improvement | TMJ

Richard B. Barry, D.D.S. & Dr. Beth Love, D.D.S. 1234 Old Henderson Road Columbus, OH 43220
Phone: (614) 451-2234 Fax: (614) 451-1511 E-mail: drbarry@pearlywhitesmile.com

Copyright © 2008 Richard B. Barry, D.D.S. Site by MarkLeder.com