:: jtortho | Virtual Smile ::

How It Works

Submit your information via the below fields and our Treatment Coordinator will get back to you as soon as possible with a preliminary treatment plan.

Please include your six photos matching what you see below. You can use two tablespoons to assist in retracting your cheeks. Hold your phone or camera horizontally and get as close as you can to your teeth while still showing the whole mouth. The more detail and clarity the better.

We look forward to creating you a WOW Smile @ jtortho

Front teeth biting down
Right back teeth biting down
Left back teeth biting down
Top teeth
Bottom teeth
Front teeth slightly open

Virtual Smile Assessment Step 1

Please check that all fields are complete and the age verification box is checked before moving on.

First Name

Last Name

Phone

DOB

I verify that I am at least 18 years old

Required fields can not be blank.

Virtual Smile Assessment Step 2

Do you have dental insurance?

If you are not sure, leave blank Yes

Have you had braces before?

If you are not sure, leave blank Yes

Treatment Preference

Ex. Braces, Invisalign, etc.

What would you like changed about your smile

Ex. Crowding, Spacing, etc.

Dentist

Preferred Office

Required fields can not be blank.

Virtual Smile Assessment Step 3

Upload Your Photos

All photos should be taken sitting in a seated position. You will need a friend or family member to serve as your photographer as its difficult to try and take each of the photos below by yourself.

For your convenience we offer Virtual Consultations!

How It Works

Front teeth biting down

Right back teeth biting down

Left back teeth biting down

Top teeth

Bottom teeth

Front teeth slightly open