Gladstone Dentist

Patient QuestionnaireGladstone, MO

Answer our Patient Questionnaire to find out about the health and beauty of your smile:

Our passion is spreading the positive message of modern dentistry. If your teeth are causing you pain, either physically or emotionally, we can help. We know that if your joints, muscles and teeth work together to form a complete, healthy oral system, then whatever improvements we make to your teeth… crowns, veneers, inlays, implants, partials etc…. will be built on a strong functional foundation. If your smile is hiding something that gives you pain, talk to us. We can make your smile beautiful from the inside out.

Request An Appointment

Do your teeth feel as though they don’t quite fit together?

Do your gums bleed when brushing or flossing?

Are your teeth sensitive to cold or hot temperatures?

Can you make either your left or right jaw joint hurt or bother you in any way when you grind your teeth?

If you have caps (crowns) or bridgework done, did it affect your speech or create pressure or discomfort in your lips?

Are previously done caps, veneers or bridgework visually undetectable? Does the restorative work look naturally beautiful?

Do you have any problems with caps, veneers or bridgework coming loose or breaking?

Special Requests:

Full Name