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Full Name*

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How's your teeth crowding?

Teeth crowding is when there is insufficient space in the mouth, teeth overlap each other and become misaligned.

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Mild

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Moderate

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Severe

I have no
teeth crowding

How's your teeth spacing?

Teeth spacing is when there are visible spaces between your teeth.

First Image Second Image

Mild

Third Image Fourth Image

Moderate

Fifth Image Sixth Image

Severe

I have no
teeth gaps

How's your bite?

Under Bite - When the lower front teeth protrude beyond the upper front teeth when the jaw is closed.
Over Bite - When the upper front teeth overlap over the lower front teeth when the jaw is closed.
Crossbite - When one or more of your teeth don't line up properly with your mouth closed.
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Underbite

First Image Second Image

Overbite

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Crossbite

I have no
bite issues

Have you gone through any of these procedures before?

Braces

Root Canal

Aligners

Implants

Whitening

None

How old are you?

Below 13
14-20
21-30
Above 30

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