Braces
Broken Teeth
Cavity
Crown
Dental Implants
Dentures
Extraction
Root Canal
Toothache
Teeth Cleaning
Veneers
Dental Exam
Other
As soon as possible
Witin 1 week
Within 2 weeks
In more then 2 weeks
Not at all nervous
A little nervous
Moderately nervous
Very nervous
Extremely nervous
Yes I'm ready
No I'm not ready
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