My Dental Wishes

1. Personal information

Name *

Date of birth

Phone number

E-mail *

4. Which dental problem do you have?Pain / Feeling of pressureGum problems ( bleeding, inflammation )Sensitivity ( too cold, warm, sweet )Problems with existing prosthodontic solutionTMJ problemsTooth displacement: Crowding teeth /Gap among the teethOthers:

5. What would you like to achieve with the treatment?Pain relief with a solution to the problemTo improve chewing and biting abilityAesthetic smileReplacement of missing teethLong-term oral health

6. Which treatment area are you interested in?A complete prosthodontic treatmentCrowns, Bridges, Veneers - aesthetic solutionsTraditional braces / AlignerPartial dentureOthers:

7. What is your priority when it comes to dental treatment?the best possible resultfast resultfavorable priceminimal invasive / tooth preservation

8. When would you like to start the treatment?immediatelyin 1-3 monthsin 3-6 monthsanytime / flexible

9. Are you usually afraid of dental treatments?YesNo

10. Is there anything else you would like to tell us?

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