Hinsdale Dentistry - Smile Analysis

Hinsdale Dentistry

Peter T. Harnois D.D.S. & Zivile Z. Chirban D.D.S.

Your smile can have a huge effect on your self confidence and can keep you from interacting with the people around you. Have you ever held back on laughter or hid your smile, even from a loved one?

The following questions are designed to honestly evaluate your smile. Take a look in the mirror and show your biggest smile. Then, ask yourself the following questions:

	Are any of your teeth yellow, stained or somewhat discolored?		Yes No
	Would you like your teeth to be whiter?		Yes No
	Do you have any gaps or spaces between your teeth?		Yes No
	Are any of your teeth turned, crooked, or uneven?		Yes No
	Are you missing any teeth?		Yes No
	Are the edges of any teeth worn down, chipped or uneven?		Yes No
	Do any of your teeth appear too small, short, large or long?		Yes No
	Do you have any prior dental work that appears unnatural?		Yes No
	Do you have any crowns or bridges that appear dark at the edge of your gums?		Yes No
	Do you have any gray, black or silver (mercury) fillings in your teeth?		Yes No
	Do you have a "gummy" smile (too much of your gums show when smiling)?		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

If you answered YES to any of the questions above, there are many way that we can help you regain a healthy and self confident 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.

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