Get your smile and confidence back with a personalized treatment plan. No pressure, no commitment.

Implant Quiz for Campaign

Step 1 of 10

10%

How Many Teeth Are You Currently Missing?*

All

3-5

2 or fewer

Are You Able To Eat Comfortably?*

I chew mostly on one side

I have pain when I chew

I limit the types of foods I can eat

I am able to eat comfortably

If This Is Your Second Consultation Please Explain Why You Would Like A Second Opinion?*

This is my first consult.

I did not feel confident in the doctor at the other practice.

I did not feel comfortable at the other practice.

I would like to compare prices.

Major Dental Treatment May Require A Substantial Financial Investment. Have You Planned On How You Will Pay For The Work Needed?*

I have good credit and would like financing arrangements.

I will pay out of pocket.

I do not have great credit and will need other financial assistance.

I have not given thought to this.

When It Comes To Your Comfort At The Dental Office Would You Say You Are:*

A Nervous Patient

Relaxed At The Dentist

Sometimes Nervous, But Mostly Okay

Why Are You Taking This First Step To Correct Your Dental Health?*

I am in pain.

I have lost confidence in my smile.

I am unable to chew.

All of the above - I'm in pain, lack confidence, & cannot chew.

What Type Of Dental Implant Solution Are You Interested In?*

Full Fixed Arch Implants - I want the best quality full mouth restoration possible, even if it's more expensive.

Implant Retained Dentures - I want an implant denture hybrid. I'm looking to balance quality with price.

Implant Bridge - I want to replace just a few missing teeth in a row.

Single Dental Implant - I'm missing one or two single teeth that need to be replaced.

How Urgent Is This Treatment To You? (How Soon Do You Want/Need To Get This Done?)*

I want this done ASAP. I'm in pain / tired of feeling sick and I'm ready to improve the quality of my life.

I want this done 1-3 months from now. I definitely want this treatment, I just need a little more time.

I'm still researching, I don't know yet.

If You Require Financing, Please Select The Option Below That Best Describes Your Credit History.*

Under 650

650-749

750+

If You Are Looking To Finance For Your Dental Treatment, Healthcare Financing Companies Will Ask For A Source Of Income. Which option best describes you?*

I work full-time

I work part-time

I am retired

I am unemployed

Should You Have Difficulty Getting Approved For Financing, Do You Have A Co-Signer To Help You?*

Yes, I have a co-signer with a 650+ credit score.

No, I don't have a Co-Signer.

Not Applicable - I have at least a 650 credit score, therefore I don't need a Co-Signer.

Although The First Appointment Is Free, We Do Expect New Patients To Respect Our Time And SHOW UP For Their Appointment. Do You Commit To Showing Up For Your Appointment At The Time It Is Scheduled?*

Yes, I commit to showing up for my consultation in Sylacauga, AL.

No, I cannot commit to showing up for my consultation in Sylacauga, AL.

Name*

First Last

Email*

Phone*

Turnstile

Benefits of Dental Implants at Southern Smiles of Sylacauga

Eat the foods you love again – Enjoy your favorite meals without worry
Speak and smile with confidence – No slipping, shifting, or embarrassment
Long-lasting, natural-looking results – Designed to look, feel, and function like real teeth
Minimally invasive procedure – Faster healing and fewer appointments
Mini Dental Implants require less bone than traditional implants – Great option even if you’ve been told you’re not a candidate