Smile Assessment

01.Me:

Mother / Father of childAdultTeenager

02.Sex:

MaleFemale

03.Your age:

< 1819-2425-3435-4445-54> 54

04.If FenixDent is right for me, I want to start treatment:

SoonIn 1-3 monthsIn 4-6 months

05.How do you think your teeth and smile look like today?

Cross Bite
Open bite
Deep bite
Excessive crowding
Interdental spaces
Mesial bite
Distal bite
Abnormal tooth placement
No tooth

06.What do you think about the gaps between your teeth? Are they too wide or normal?

Cropped
upper jaw
Gaps between teeth
Cropped
Congruent mandible
Gaps between teeth

07.Please fill in the contact details here.