DentalMagic

Patient Name *

Patient Phone (for SMS sharing) Patient Photo

💡 Best results: relaxed open smile, upper teeth visible, NOT biting or clenching

👑 Crown Jewel Feature

Patient records a short video saying "This is my new smile!" — we transform their teeth in the video

Treatment Smile Type Tooth Shade 🎬 Auto-generate video after smile

Video takes ~3 minutes. Starts automatically after your smile generates.

📋 Treatment Plan & Patient Record

DentalMagic Lite — Clinical Consultation

First Name *

Last Name *

Phone *

Treatment Arch *

Extractions needed?

🦷 Upper Arch (Maxilla)

Sinus lift needed?

Number of implants — Upper

Type of restoration — Upper

🦷 Lower Arch (Mandible)

Bone graft needed?

Number of implants — Lower

Type of restoration — Lower

Additional Clinical Notes

Estimated Treatment Value ($)

Removes from patient database. Photos on AI servers expire automatically within 24hrs per our privacy policy.

Share Results with Patient

Patient consent required before sharing photos via SMS

First Name *

Last Name *

Date of Birth *

Phone *

I consent to receiving my smile transformation results via SMS. I understand this is a simulation for visualization purposes only and not a guarantee of treatment outcomes. (HIPAA Authorization) Patient Signature *

Sign above with your finger

🦷 DentalMagic

Share Results with Patient

Confirm & Send