Dr. Jack Ringer • Advanced Smile Design • 714-974-0313

Get Your Attractive Smile Quotient Rating (ASQ)

Claim a free gift and discover the full potential of your smile by filling out Dr. Jack Ringer’s Proprietary Smile-Assessment Tool.
Each checked question reflects a percentage subtracted from the positive features of one's smile. The final ASQ number is calculated based on your input into the ASQ questionnaire; and can be done before and after treatment for comparison.

	Your Attractive Smile Quotient Rating (ASQ)
	Name	E-Mail	Phone

Check the items that apply to you.
	1. Do you feel uncomfortable about showing your teeth when you smile?
	2. Do you find yourself covering your smile with your hand?
	3. Do you tend to smile with your lips sealed?
	4. Do you have pain or discomfort with any of your teeth?
	5. Do you dream of whiter, brighter and better looking teeth?
	6. Do you have teeth that are stained, yellow, gray or blue?
	7. Do you show too much of your gum when you smile?
	8. Do you show more teeth on one side of your mouth when you smile?
	9. Do you have teeth that are crooked or out of alighnment?
	10. Do you have a missing tooth or teeth?
	11. Do you have or show misshapen teeth?
	12. Do you have any unsightly cosmetic dentistry previously done?
	13. Do you show ugly dental fillings?
	14. Do your teeth appear to slant when you smile?
	15. Do you have receding gums?
	16. Do you have teeth with biting edges that are worn down?
	17. Do any of your teeth appear chipped, rough or sharp?
	18. Do you have teeth that are too large or too small?
	19. Do you desire positive changes to your life by maximizing your smile's potential?
	20. What do you want to change about your smile?

	21. How did you hear about us? If you don't find the answer in the popup, enter it here.

Dr Ringer practices general family and restorative dentistry and is President of the AACD (American Academy of Cosmetic Dentistry) and an accredited cosmetic dentist (only one of 5 in Orange County and one of 300 worldwide), and is certified as a dental sleep medicine practitioner by the American Academy of Dental Sleep Medicine. Dr. Jack Ringer is the President of OCACD (Orange County Academy of Cosmetic Dentistry) and has been serving Orange County, California, located in Anaheim Hills near our neighbors in Yorba Linda, Villa Park, Orange and surrounding communities for almost 30 years.

A nationally renowned lecturer in contemporary esthetic dentistry, Dr. Jack Ringer is faculty mentor for the Spear Institute at the Scottsdale Center in Arizona, a faculty member for the Esthetic Professionals Dental Education and Training Center in Tarzana California, and is past Associate Professor at Loma Linda Dental School and past Assistant Clinical Director for Center for Esthetic Dentistry at UCLA.