Smile Lincs Assessment Form

Have some fun with our Online Assessment Form!
Tick all that apply in your case.

Are you self-conscious about your teeth when you smile?
Do you wish your teeth were whiter?
Do you wish your teeth were shaped differently?
Do you show any discoloured teeth when you smile?
Do you wish your black fillings where tooth coloured?
Do you have any old crowns that show dark lines at the gums?
Do your gums bleed easily when you brush?
Do you have an old denture that does not fit well or look good?
Do you have any sensitive teeth?
Are you concerned that you may have bad breath?
Do you have any missing teeth that you would like replacing?
Do you snore? Will you be interested in getting rid of this problem?


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