Virtual Smile Assessment Step 1

Please check that all fields are complete and the age verification box is checked before moving on

Please make sure your email address is formatted properly: [email protected]

Do you have dental insurance?
If you are not sure, leave blank
Do you qualify for medicaid?
If you are not sure, leave blank
Have you had braces before?
If you are not sure, leave blank
Treatment Preference
Ex. braces, clear braces, etc.
What would you like fixed about your smile?
Ex. crowding, spacing, etc.

Please make sure you have uploaded all 3 images

Upload Your Photos

All photos should be taken sitting in a seated position. You will need a friend or family member to serve as your photographer as it’s difficult to try and take each of the photos below by yourself.

Images must be a .jpg, .jpeg, .png, or .gif and cannot exceed 20MB.

frontal image

Photo 1

Frontal Smiling

Bite down and give a really big smile. Make sure your back teeth are touching.

second frontal image

Photo 2

Frontal Gums

Smile very big again, but this time keep your teeth slightly apart and pull back your lips with your fingers so your top and bottom gums are visible.

profile image

Photo 3

Profile

Smile really big (one more time!) and bite down on the back teeth - the way you would if you were chewing something. In this photo we need to be able to see both the bottom and top teeth.

Please make sure you have uploaded all 3 images

Additional Comments

Almost Finished!

Please check the box below and click the SUBMIT button to send your assessment to the doctor.

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