Bettersmiles
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Please help us determine if a BetterSmiles appliance is the best solution for you
Enter the Following information below
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1Are you missing one or more teeth and are you over the age of 18?
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Yes
No
2Select the arch(es) that you wish to replace missing teeth:
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Top
Bottom
Both
aAre you missing all your teeth on your Top Arch?
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Yes
No
bAre you missing all your teeth on your Bottom Arch?
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Yes
No
cAre you missing all your teeth from either your Top Arch OR your Bottom Arch?
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Yes
No
3 Do you have at least 4 teeth that are stable (not loose) on the arch(es) you would like to restore?
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Yes
No
4 Do you have any broken teeth next to the missing teeth you wish to replace?
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Yes
No
5 Do you have any cavities or holes in the teeth next to the missing teeth you wish to replace?
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Yes
No
6 Have you had any teeth extracted in the past four months?
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Yes
No
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