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Facts About Periodontal Therapy

How to Regrow Lost Bone

Facts About Implant Therapy

Milton Dental Implant Study

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Milton Dental Implant Study

Benefits of Participation - Help us to serve you better

Please take a few minutes to fill out the questionnaire below, in the interests of both science and patient care.

Name:

Address:

Preferred Phone#:

I am missing all of my teeth in my:

I have been missing the teeth
in my upper arch for:

years

I have been missing the teeth
in my lower arch for:

years

Strongly Disagree

Disagree

No Opinion

Agree

Strongly Agree

I am satisifed with the esthetics of my denture(s)

I am comfortable functioning
with my denture(s)

I eat whatever I wish to with no second thoughts with my denture(s)

I am comfortable speaking with my denture(s)

My overall satisifaction with my denture(s) is

poor

fair

good

very good

excellent

Please check if another household member is missing all teeth in their upper, lower, or both arches

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