Mary Swift, DDS – General Dentist   &   Alana Reifer, DDS – General Dentist   

QuestionAnswer
How often do you have your teeth cleaned?Y / N / DK
How often do you brush your teeth?Y / N / DK
How often do you floss your teeth?Y / N / DK
Do you grind or clench your teeth?Y / N / DK
Do you bite your fingernails?Y / N / DK
Do you chew on pens or pencils?Y / N / DK
Do you smoke?Y / N / DK
Do you drink coffee or hot tea?Y / N / DK
If so, how many combined cups per day?Y / N / DK
Do you drink iced tea or colas?Y / N / DK
If so, how many per day?Y / N / DK
When you look in the mirror, do you like the appearance of your teeth?Y / N / DK
Do you like the length of your teeth?Y / N / DK
Do you like the shape of your teeth?Y / N / DK
Do you have an stained teeth?Y / N / DK
Do you like the color of your teeth?Y / N / DK
Would you like your smile to look 10 years younger?Y / N / DK
Do you have any spaces between your teeth?Y / N / DK
Do you have any teeth with white spots?Y / N / DK
Do you have any chips or cracks in your teeth?Y / N / DK
Do you have any crooked teeth?Y / N / DK
Are you missing any teeth?Y / N / DK
If so, would you like to have the missing teeth replaced?Y / N / DK
Do you have any silver fillings you’d eventually like replaced with tooth-colored ones?Y / N / DK
Do you have any teeth you believe need caps or bonded porcelain inlays?Y / N / DK
Do you have any caps that have metal showing through, or are unattractive to you?Y / N / DK
Have you had braces in the past?Y / N / DK
If yes, were you pleased with the results?Y / N / DK
If yes, have you continued to wear your retainer, at least at nighttime?Y / N / DK
Have you ever had or considered any cosmetic surgery?Y / N / DK
Would you like to see what you would look like with a great smile?Y / N / DK

If you answered “Yes” to any of these questions there’s good news – we can provide you with a more beautiful smile!

  • To learn more about our cosmetic and therapeutic treatments available, simply click here
  • Or, if you’re ready to take the next step, please contact us now!
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