Try In Approval Form

Please correct the errors described below.
  • Porcelain Restorations
  • Composite Restorations
  • Denture Teeth

I approve the color, shape, size, amount of tooth that shows when I smile, my lip support (fullness), and the overlap of the front teeth (upper and lower teeth bite together the way I like).

I approve the restorations to be completed. I understand that bite adjustments will likely need to be made afterwards. I understand that changes relating to the color, shape, and position of the teeth after completion will involve removing and remaking the restorations. This could result in further reduction of tooth structure and an additional full fee for the replacement.

By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.

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