Preferred Method of Communication
If you can submit your photos, that will help us determine your treatment plan before your visit! Photos are optional but recommended 🙂
#1 Lower Teeth
Open your mouth wide and tilt your chin downwards toward your chest. Hold the camera so it’s perpendicular to the biting surfaces of your bottom teeth. Make sure your full arch is showing and then snap a picture.
#2 Upper Teeth
Open your mouth wide and lift your chin as high as you can. Hold the camera so that it’s perpendicular to the biting surfaces of your top teeth. Make sure you can see the full arch and then click.
#3 Front View, smiling
Bite down so your back teeth touch. Directly facing the camera, smile wide and click, trying to get as many teeth as you can in the picture. If you need to, you can pull your lips and cheeks away from your teeth with your fingers to show more teeth.
#4 Right View
Bite down so that your back teeth touch, smile and retract the cheek and lips with your finger on the right side of your mouth to expose more of your teeth. Take a picture of the right side.
#5 Left View
Bite down so that your back teeth touch, smile and retract the cheek and lips with your finger on the left side of your mouth to expose more of your teeth. Take a picture of the left side.
*maximum upload file size 1MB Each
Who Referred You?
Name of Your Dentist
Do you prefer braces or clear aligners?Clear alignersBraces
Have you worn braces or invisible aligners in the past?YesNo
Choose the option that best describes your biggest concern with your smile:Fix a spacing issueFix a crowding issueFix a bite problem (overbite, underbite or crossbite)Generally straighter teeth
Of the images below, which one best describes your teeth crowding?
mild, or no crowdingmoderateextreme
Of the images below, which one best describes your teeth spacing?
mild, or no extra spacemoderateextreme
Of the image below, which best describes your current orthodontic situations?
Crossbite (Back Teeth)Crossbite (Front Teeth)CrowdingSpacingOverbiteOverjetAbnormal EruptionOpen Bite
1455 Harvey Ave #10 (Highway 97 North)Kelowna, BC V1Y 6E9