The Objective Smile Evaluation - Prosthodontist in Johannesburg
16615
page-template-default,page,page-id-16615,ajax_fade,page_not_loaded,,qode-theme-ver-9.5,wpb-js-composer js-comp-ver-4.12,vc_responsive
 

The Objective Smile Evaluation

Complete Our Smile Evaluation Questionnaire & Submit Your Answers To Dr Kaplan

Are all of your teeth brilliant white or are they somewhat yellow, dark, or stained?
Brilliant WhiteWhiteYellowDiscolouredDarkStained

Are there spaces between any of your teeth?
YesNoMaybeStained

Are you missing any of your teeth?
YesNoMaybeStained

Number Missing
12345678910111213141516171819202122232425262728

Do you have teeth that are crooked, uneven, or out of line?
YesNoMaybe

Do the biting edges of your upper teeth follow the curvature of your upper lip?
YesNoMaybe

Do any of your teeth appear short and fat or too small or too large?
YesNoMaybe

Are the edges of any of your teeth even with the rest of your teeth or are they too long or too short?
YesNoMaybe

Do your teeth (as a group) slant one way or another?
YesNoMaybe

Is the midline of your two front teeth centered with your face and nose?
YesNoMaybe

Are the edges of your canine teeth too long, sharp, or look out of line?
YesNoMaybe

Do you grind your teeth or are any of the biting edges on your teeth chipped or worn down?
YesNoMaybe

Do you have a "gummy" smile -- showing too much gum tissue or having gums that are too thick?
YesNoMaybe

Are your gums even and in line and symmetrical or irregularly shaped -- higher on some teeth and lower on others?
SymmetricalIrregularly shapedUneven

Have your gums receded or do they appear red or puffy?
RecededRedPuffyNon

Do you have any gray, black or silver (mercury) dental fillings in your teeth?
YesNoMaybe

Do you have any old crowns that have dark edges at the top or that don't really look natural?
YesNoMaybe

Would you like to book an appointment with Dr Kaplan to discuss your results?
YesNo

Your Name (required)

Your Email (required)