Upload your smile, fill in the form below and we’ll respond you with a virtual consultation ! Remember that the more descriptive you are, the more effective the email will be. Start by click-ing on the link.
Your name (mandatory)
Your email (mandatory)
Your phone number
Your date of birth
Do you smoke?
Do you consume regularly ?
Soda Coffee Tea Wine
Do you have a disease that can affect the appearance of your teeth ?
Have you followed orthodontic treatment ?
If yes, When?
Do you think that your teeth are a matter of? Of primary importance Very important Important but not a major concern
Are you embarrassed by the appearance of your teeth ?
What would you change first of all in the appearance of your teeth ?
When you smile or laugh, you fear that the eyes of others is drawn to some aspect of your mouth ?
Do you put your hand in front of your mouth when you smile?
Do you feel that your teeth are ?
Too short Too long Too narrow Too wide Too round Too square Normal
Have you broken, damaged or missing teeth ?
If yes, are they visible when you smile?
Do you find the color of your teeth ?
To white White Yellow Gray Brown
Do you have stains on your teeth?
Do you think that your teeth are aligned ?
Do you have spaces between teeth ?
Do you have an incomplete or missing tooth ?
Do you have fillings or crowns ?
If yes, when you smile, do you see your fillings or crowns ?
When you smile, do you find that your gums are ?
Visible To visible Normal
Are you reluctant to smile ?
Do you have a specific request or concern?
Are you reluctant to smile?
Upload your smile: Send us your smile and we will respond within 48 hours with a virtual consultation!