We are excited to offer you a complimentary, virtual hand-crafted smile experience!

How It Works

Please submit your information via the fields below, and we will reach out to you as soon as possible to schedule a virtual consultation with your doctor and treatment coordinator, at your convenience!

Include your six photos, matching what you see below. You can use two home objects, such as spoons, to assist in retracting your cheeks. In bright lighting, hold your camera horizontally and get as close as you can to your teeth, while still showing the whole mouth. In any photo you take and the example is biting down, please stick your tongue to the roof of your mouth and as far back as possible, and bite on your back teeth. The more detail and clarity, the better your doctor can use these photos for the diagnostic process.

We look forward to creating your handcrafted smile @Western Springs Orthodontist

  • 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.

Virtual Smile Assessment Step 2

Do you have dental insurance?

If you are not sure, leave blank

Have you had braces before?

If you are not sure, leave blank

Treatment Preference

Ex. Braces, Invisalign, etc.

What would you like changed about your smile

Ex. Crowding, Spacing, etc.

Dentist

Preferred Office

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.

Images must be a .jpg, .jpeg, .png, or .gif and cannot exceed 20MB.

These are photos of:

Photo 1

Front teeth biting down

Photo 2

Right back teeth biting down

Photo 3

Left back teeth biting down

Photo 4

Top teeth

Photo 5

Bottom teeth

Photo 6

Front teeth slightly open

Patient virtual consultation submissions are protected and encrypted by LuxSci