Smile Questionnaire for FREE Smile analysis (Tick where applicable)

I would like to have whiter teeth
I would like to have straighter teeth
I would like to have better shape of my teeth
I would like to have Longer/Shorter teeth
I would like to repair broken/fractured teeth
I hate the black fillings on my teeth
I have gaps between my teeth
My gums are at different levels
My gums are dark colored
All my teeth are not of same color
I am worried about the cracks on my teeth
I cover my mouth when i smile
My teeth are not visible when i smile
My gums are too much visible when i smile
I do not have a confident smile
I want to replace my missing teeth
I want to change my ill fitting dentures
My teeth are becoming smaller with time
My teeth are becoming thinner with time
I will feel more confident if i change my smile
*Select at-least one option form the above list.