Teeth-in-a-Day Candidate New London, CT Westerly, RI

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Find Out if You’re a Candidate for All-on-4® or Teeth-in-a-Day®

There are many people that are told every day that they do not qualify for dental implants due to bone loss or other related conditions. Due to our experience and technology 90% of those people are still candidates for this procedure.

Are you Currently in Dentures?

YesNo

Are you missing more than 4 teeth?

YesNo

Are your teeth mobile?

YesNo

Did the dentist indicate that you were a candidate for implants, All-on-4® or Teeth-in-a-Day®?

YesNo

Do you have periodontal disease?

YesNo

Have you had any recent consultation with a dentist?

YesNo

Do you have uncontrolled Diabetes?

YesNo

I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privcy regulations and the HITECH act.