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Interactive Consultation

It’s our mission to make quality dental care as accessible and convenient as possible. That’s why we’ve created our no strings-attached Interactive Consultation. Use the form below to tell us about your smile and any issues you’re experiencing.
Our experienced Treatment Coordinator will review your information and come back to you with an idea of the treatments that we can offer to make your smile healthy and bright and the costs involved*.

    How can we help?

    Tick the statement that describes your wishes

    Teeth chart

    Show us the teeth that are causing you concern by selecting them below then tell us the issue you’re experiencing in the comments box.

    • X
    Upper Arch
    Please select
    the affected
    teeth/areas
    Lower Arch
    Please select
    the affected
    teeth/areas

    Describe the issue relating to the teeth you have selected

    Smile evaluation

    Select ‘yes’ or ‘no’

     

    • Do you like the way your teeth look?

    • Are you happy with the colour of your teeth?

    • If you could whiten your teeth for an affordable price, would you be interested?

    • Do you wish your teeth were shaped differently?

    • Do you have any spaces between your teeth that you would like closed?

    • Do you have missing teeth that you want to replace?

    • Do you have fillings that don’t match the colour of your teeth?

    • Do you have discoloured teeth that embarrass you?

    • Do you wear a denture? Would you prefer a fixed and permanent solution?

    • Do your gums appear red and swollen when you brush them?

    • Can you eat anything you like without pain or discomfort?

     

    Yes Please tick box for more information on any upcoming offers

     

     

     



    Smiles Dental Privacy Policy

    We recognise that when you give us personal information (which includes health information) you’re trusting us to take good care of it.
    Please see our privacy policy for more information about how we collect, use and protect your data. If you don’t want to receive marketing about Bupa products and services that we think are relevant to you, please contact us at optmeout@bupa.com.

    *Please note for comprehensive clinical advice you will need to attend a consultation in person. The purpose of the Interactive Consultation is to provide an estimate of appropriate treatments and costs only. We will do this to the best of our ability, based on the information provided by the user.

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