Mark F. Maxwell, DDS, MS, Inc

Your smile affects your self-image, and can greatly influence the quality of your interactions with others. Many people hold back from laughing or smiling because they are uncomfortable with their smile. The following questions are designed to honestly appraise your smile. Go to a mirror, smile as wide as you can, and ask yourself the following questions:

	Do you have any gaps or spaces between your teeth?		Yes No
	Are any of your teeth turned, crooked, or uneven?		Yes No
	Do you have a "gummy" smile (too much of your gums show when smiling)?		Yes No
	When being photographed, do you smile with your lips closed instead of flashing a full smile?		Yes No
	Are any of your teeth yellow, stained or somewhat discolored?		Yes No
	Are you self-conscious about your teeth or smile?		Yes No
	Does the appearance of your smile inhibit you from laughing or smiling?		Yes No
	Would you like to change anything about the appearance of your teeth or smile?		Yes No
	Do any of your teeth appear too small, short, large or long?		Yes No
	Do you have any TMJ symptoms? Joint Pain, Head Aches, Neck Aches, Limit Mobility, Ear Problems, Sinus Issues		Yes No
	Does your bite feel uneven?		Yes No
	Do you have excessive gingival recession?		Yes No
	Do you snore or have sleep apnea?		Yes No

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.

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