| Are any of your teeth yellow, stained or somewhat discolored? |
| Would you like your teeth to be whiter? |
| Do you have any gaps or spaces between your teeth? |
| Are any of your teeth turned, crooked, or uneven? |
| Are you missing any teeth? |
| Do you see any pitting or defects on the surfaces of your teeth? |
| Are the edges of any teeth worn down, chipped or uneven? |
| Do any of your teeth appear too small, short, large or long? |
| Do you have any prior dental work that appears unnatural? |
| Do you have any crowns or bridges that appear dark at the edge of your gums? |
| Do you have any gray, black or silver (mercury) fillings in your teeth? |
| Do you have a "gummy" smile (too much of your gums show when smiling)? |
| Are your gums red, sore, puffy, bleeding or receded? |
| Does the appearance of your smile inhibit you from laughing or smiling? |
| When being photographed, do you smile with your lips closed instead of flashing a full smile? |
| Are you self-conscious about your teeth or smile? |
| Would you like to change anything about the appearance of your teeth or smile? |