Patient Questionnaire

Answer our Patient Questionnaire to find out about the health and beauty of your smile:

Our passion is spreading the positive message of modern dentistry. If your teeth are causing you pain, either physically or emotionally, we can help. We know that if your joints, muscles and teeth work together to form a complete, healthy oral system, then whatever improvements we make to your teeth… crowns, veneers, inlays, implants, partials etc…. will be built on a strong functional foundation. If your smile is hiding something that gives you pain, talk to us. We can make your smile beautiful from the inside out.

Do your teeth feel as though they don’t quite fit together?
   Yes           No                     
• Do your gums bleed when brushing or flossing?
   Yes           No        
• Are your teeth sensitive to cold or hot temperatures?
   Yes           No                      
• Can you make either your left or right jaw joint hurt or bother you in any way when you grind your teeth?
   Yes           No        
• If you have caps (crowns) or bridgework done, did it affect your speech or create pressure or discomfort in your lips?
   Yes           No        
• Are previously done caps, veneers or bridgework visually undetectable? Does the restorative work look naturally beautiful?
   Yes          No        
• Do you have any problems with caps, veneers or bridgework coming loose or breaking?
   Yes          No        

If you have answered “yes” to one or more of these questions, let us know. We can help!

Request a Consult

Contact Us

  • Oak Harbor Family Dentistry
  • Michael J. Appleton, DDS
  • Erin A. Fontenot, DDS
  • 480 Oak Harbor Blvd.
  • Slidell, LA 70458

  • Phone: (985) 649-9455

  • E-Mail the Doctor

Request More Info