Upload Your Smile Your name * Your e-mail address * Your city Your state - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Your age Upload Your Smile Upload More informationFiles must be less than 2 MB. Allowed file types: gif jpg png. Your Smile Analysis Please look into the mirror and evaluate your smile How many teeth do you show with your best smile? My teeth seem too dark. No Yes How would you describe their color and shade? very whitemoderate - whitelight - yellowmoderate - yellowdark - yellowlight - browndark - brownmoderate - greydark grey How are color and shade distributed? Uneven Even Do you have white or discolored spots on your teeth? No Yes Do you see any pitting or defects on the surface of your teeth? No Yes Do your front teeth have any visible fillings and/or crowns? No Yes Are your teeth crowded? No Yes Do you have spaces between your teeth? No Yes How many? What shape and size do your teeth have? Please choose one value per section. Section 1 LongShortNormal Section 2 NarrowWideNormal Section 3 LargeSmallNormal Section 4 SquareRoundTapered Section 5 IrregularRegular I see significant differences between neighboring teeth. No Yes I show my gums when I smile. No Yes I like the amount of gums that I show. No Yes How would you describe your lips? Very Full Full Normal Narrow Is there anything you would like to mention about your smile? How did you find us? (Use the text area for your comments) I want to stay current on all latest advances in smile improvement technology, so please send me more information No Yes Submit
