Do I feel uncomfortable or self-conscious about my smile? ---NOYES
Do I cover my mouth when I talk or smile? ---NOYES
Are my teeth in alignment (straight)? ---NOYES
Do I wish my teeth were whiter? ---NOYES
Do I like the shape of my teeth? ---NOYES
Are my teeth chipped? ---NOYES
Do I have dark restorations in my teeth? ---NOYES
Do I have old crowns, bridges, or fillings that I don't like? ---NOYES
Am I concerned about breath odors or bad taste in my mouth? ---NOYES
What would I like my smile to look like?
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