CLÍNICA DENTAL INTERNACIONAL Pedro Amor Koole
Questionnaires
  • Are you candidate for cosmetic dentistry?

  • 1. Are you self confident about smiling?
    YES NO

  • 2. Do you ever put your hand over your mouth when you smile?
    YES NO

  • 3. Do you photograph better from one side of your face?
    YES NO

  • 4. Is there someone you believe has a better smile tan you?
    YES NO

  • 5. When you look at your smile in the mirror, do you see any defects in your teeth or gums?
    YES NO

  • 6. Do you wish your teeth were whiter?
    YES NO

  • 7. Are you satisfied the way your gums look?
    YES NO

  • 8. Do you show too many or too Little teeth when you smile?
    YES NO

  • 9. Do you show too many or too Little gum when you smile?
    YES NO

  • 10. Are your teeth too long or too short?
    YES NO

  • 11. Are your teeth to wide or too narrow?
    YES NO

  • 12. Are your teeth too square or too round?
    YES NO

  • 13. Do you like the way your teeth are shaped?
    YES NO

    * ALL fields are required.

    • Call us... and smile! (00 34) 96 571 75 12
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    Paseo de La Libertad, 2 - 4°B - 03181 TORREVIEJA (Alicante, Spain)
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