Oldham Orthodontics Smile Analysis

1

Who's smile are you interested in improving?* This field is required.

❤️ Family member

🙋‍♂️ Hi! It's me...

2

Which of these is the highest priority for improving your smile?* This field is required.

🦷 Teeth Straightened

😁 A Healthier Bite

✨ Both!

3

Which of these is the highest priority for improving their smile?* This field is required.

🦷 Teeth Straightened

😁 A Healthier Bite

✨ Both!

4

Which image looks closest to their smile?* This field is required.

5

Which image looks closest to your smile?* This field is required.

6

Which of these is the biggest motivation to seek treatment?* This field is required.

Give them a confident smile

Their teeth hurt

Their bite feels off

They can't eat well

Other

7

Which of these is the biggest motivation to seek treatment?* This field is required.

I don't like my smile

My teeth hurt

My bite feels off

I can't eat well

Other

8

ALMOST DONE! Which is MOST important when it comes to treatment?* This field is required.

Shhhh! Being as discreet as possible.

Eating whatever they want!

They're fine with traditional metal brackets :)

Other

9

ALMOST DONE! Which is MOST important when it comes to treatment?* This field is required.

Shhhh! Being as discreet as possible.

Eating whatever I want!

I'm fine with traditional metal brackets :)

Other

10

Please provide their info to discover their best smile options* This field is required.We will review your smile and offer solutions tailored to them!

11

Please provide your info to discover your best smile options* This field is required.We will review your smile and offer solutions tailored to you!

12

When is the best time to schedule a FREE orthodontic consultation?* This field is required.Choose best time and day of the week

AM - Coming with coffee!

PM - After lunch, please!

Monday

Tuesday

Wednesday

Thursday