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- Dr. Elliot Davis
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Tinnisense Dentistry
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Same Day Appointments

Meet Dr. Elliot Davis
- Reviews
Tinnisense Dentistry
Get Started
News
For Professionals
- Tinnisense Science
- Tinnisense Discovery Path
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Cookie Policy

Tinnisense Dental Aligners Questionnaire

Kindly fill out the items below and someone will contact you shortly.

1) I am:(Required)

An adult considering Tinnisense Dental Aligners

A teen considering Tinnisense

An adult considering Tinnisense for my child

Other

Please Specify "Other"

2) Which best describes the orthodontic therapy you've had in the past?(Required)

Braces

Orthodontic aligners

Retainers

Palate expander

Removable device

Headgear

Space maintainer

Never had orthodontic treatment

Other

Please Specify "Other" orthodontic therapy you've had in the past

2a. If you've experienced dental braces relapse (some teeth have moved) - when did you first become aware of the problem?(Required)

Less than 1 year

1-5 years

5-20 years

20+ years

Not applicable

3) Do you have all of your adult teeth (except for wisdom teeth)?(Required)

Yes

No

Other

Please Specify "Other"

4) What do you hope to achieve from Tinnisense Aligner Care? (please select as many as you'd like)(Required)

Healthier gums and bone

More even bite

Healthier teeth

Less crowding

Straighter teeth

Reduce the overbite

Make brushing easier

Reduce underbite

Make flossing easier

Reduce staining and plaque buildup

Close gaps

Improve my smile

Increased confidence

Improve my profile

Not applicable

5) How many times per day do you floss?(Required)

0

1

2 or more

6) How many times per day do you brush?(Required)

0

1

2 or more

7) Which statement(s) do you agree with? please select as many as you'd like(Required)

A healthy mouth is an important part of my overall health

A beautiful smile is very important to me

My primary goal is to have straight teeth, but, general dental health is important, too

My primary goal is to have excellent dental health

None of the above

8) Do you have any orthodontic insurance coverage?(Required)

Yes

No

I don't know

9) Can you benefit from a health savings account (HSA) or a flexible spending account (FSA)?(Required)

Yes

No

I don't know

10) If everything works out, when would you like to start Tinnisense ?(Required)

Immediately

Next month

In the next 6 months

When I can arrange the finances

11) How much research have you done?(Required)

Just started

Spoke with my dentist about Orthodontic Aligners but have not had an evaluation

Have an appointment scheduled for an evaluation

Had an Orthodontic Aligner consultation and would like a second opinion

Ready to schedule an appointment to start Tinnisense Dental Aligner treatment

Other

Please Specify "Other" research have you done

12) Have you ever been told that you were not a candidate for Orthodontic Aligners?(Required)

Yes

No

I don't know

13) If you have had an Orthodontic Aligner-Specific Consultation, was your treatment classified as(Required)

Standard

Advanced

Complex

Not applicable / I don't know

14) Would you be opposed to having your teeth whitened during the therapy?(Required)

Yes

No

I don't know

About You

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

How Can We Reach You?

We would love to chat with you. How can we get in touch?

Preferred Method of Contact(Required)

Your Phone

Best Time to Call You

What's on your mind?

Please let us know what's on your mind. Have a question for us? Ask away.

Your Comments/Questions

Name

This field is for validation purposes and should be left unchanged.

Transform Your Life

Meet Dr. Davis

Tinnisense Sleep

Manhattan Location

80 5th Ave. #1607
(13th & 14th Streets)
New York, NY 10011
(212) 645-9255
Office Hours:
Monday - Friday
10:00 am – 4:00 pm
Map and Directions
Make An Appointment

Bronx Location

1332 Metropolitan Ave
(Parkchester stop)
Bronx, NY 10462
(718) 892-1676
Office Hours:
Select Saturdays
9:00 am – 3:00 pm
Map and Directions
Make An Appointment

What Is Tinnisense Dental Care?

Divign Dental Care is a superior and unique aligner treatment for gums, smile, bite, and sleep.

Learn More

Privacy Policy
Cookie Policy
Investors & Licensees

Tinnisense Sleep therapy has helped some with sleep apnea who have trouble breathing while sleeping and use CPAP machines.

Read about a permanent solution using Tinnisense Aligner Care.

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