Do you have concerns about? (please check all that apply) Gaps or Spaces between Teeth Color of Teeth Shape of Teeth Size of Teeth Show too much Gum Symmetry of Teeth Position of Teeth (crooked or crowded) Teeth Chipped or Broken Discolored Restorations (i.e. existing crowns, fillings, bonding) front teeth and/or back teeth Inflamed or Bleeding Gums What do you like best about your smile? What do you like least about your smile? Comments or Questions:
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