Know which full-mouth reconstruction leads are worth consultation time
Patients tell you their main issue, how many teeth are affected, and whether they're in pain, while uploading photos or prior X-rays right from the intake form. Cliont scores each response so your team can see which full-mouth cases are ready for a consultation before you pick up the phone.
The exact intake your full-mouth reconstruction leads complete
This is the real 5-question guided intake for Full-Mouth Reconstruction — the same flow your customers finish before you ever pick up the phone.
What a qualified full-mouth reconstruction lead should tell you
Rebuilding most or all teeth through a combination of restorative treatments—crowns, bridges, implants, or dentures—typically triggered by widespread decay, severe wear, multiple missing teeth, or bite collapse.
- Best Describes Main Issue
- How Many Teeth Affected
- Already Had Dental Evaluation
- Experiencing Pain, Swelling, Or
- Soon Would Like Begin
The questions your team needs answered
Every full-mouth reconstruction intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Which best describes the main issue affecting your mouth? | The main issue selected separates structural cases like severe wear or missing teeth from lower-weight cosmetic-only concerns, shaping how urgently the case should be reviewed. |
| Approximately how many teeth are affected or missing? | The number of teeth affected is the clearest sizing signal for how extensive—and how much chair time—the reconstruction will require. |
| Have you already had a dental evaluation or X-rays for this issue? | Knowing whether a prior evaluation or X-rays exist tells your team how much diagnostic work needs to happen before or during the first consultation. |
| Are you currently experiencing pain, swelling, or infection? | Active pain, swelling, or infection is a distinct clinical signal that can matter for scheduling priority regardless of how the patient answered the scope questions. |
| How soon would you like to begin treatment? | The stated timeline shows whether the patient is ready to commit to a multi-visit reconstruction plan or is still in the early exploration stage. |
How Cliont scores full-mouth reconstruction leads
Every answer is weighted automatically — no manual review required.
Value signals
- Multiple missing teeth
- Widespread decay or infection
- Bite alignment or jaw pain
- Cosmetic appearance only
- Not sure
- 1-3 teeth
Urgency signals
- Severe wear or broken teeth
See the lead your team receives
Full-Mouth Reconstruction Lead
From first click to qualified lead
Follow patients and caregivers through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the visit
Smart questions adapt to their visit and capture the full scope.
They share details
Symptoms, history, and documents come attached before the visit.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for full-mouth reconstruction workflows
| Cliont capability | Full-Mouth Reconstruction application |
|---|---|
| Weighted scoring engine | Combines the main issue and number of teeth affected to separate high-scope reconstructions (most or all teeth, severe wear) from lower-weight cosmetic-only enquiries. |
| Document and photo upload | Lets patients attach prior X-rays or evaluation records referenced in the intake, so your team knows what diagnostics already exist before the consultation. |
| Conditional field logic | Surfaces pain, swelling, or infection status as its own data point, independent of teeth count, so clinically relevant answers aren't buried under general severity scoring. |
| CRM routing | Sends scored full-mouth reconstruction leads directly into your CRM pipeline instead of a shared inbox, so higher-scope cases don't sit behind smaller single-tooth requests. |
Common full-mouth reconstruction lead scenarios
Most or all teeth affected
Patient selects severe wear or multiple missing teeth as the main issue and confirms most or all teeth are affected—this combination scores highest and should reach the front desk fastest.
Active pain or infection
Patient reports current pain, swelling, or infection alongside widespread decay, so the intake surfaces the clinical urgency even if they haven't decided on a timeline yet.
Cosmetic-only enquiry
Patient picks cosmetic appearance as the main concern and says they're just exploring options—this scores lower than structural cases, letting staff route it as a lower-priority follow-up.
Unsure of the diagnosis
Patient marks 'not sure' for both main issue and number of teeth affected, but the intake still captures pain status and prior evaluation history so a consult can still be scheduled without a phone tag round.
Second opinion with existing records
Patient has already had X-rays or an evaluation elsewhere and only 1-3 teeth are affected, indicating a smaller-scope case that may still warrant a full-mouth conversation.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book visits
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More restorative dentistry intake templates
Full-Mouth Reconstruction lead-intake FAQs
How does the intake decide which full-mouth cases deserve a consultation slot first?
It weighs the main issue selected against how many teeth are affected—cases involving most or all teeth, severe wear, or widespread decay score highest, while cosmetic-only or single-tooth concerns score lower.
What happens if a patient already has X-rays or a prior evaluation?
The intake asks that directly, so your team knows upfront whether diagnostic work is already available or needs to be scheduled before the first consultation.
Does the intake flag patients who are currently in pain or have an infection?
Yes, current pain, swelling, or infection is captured as its own answer, separate from how many teeth are affected, so staff can spot cases that may need faster attention.
What if a patient isn't sure what's actually wrong?
The intake includes 'not sure' as a valid answer for both the main issue and the number of teeth affected, so those leads still get captured and scored rather than dropped.
Should cosmetic or single-tooth cases go to a different intake instead?
If a patient's concern is really about one tooth, your Dental Crown or Inlay/Onlay intake may be a better fit—this full-mouth intake is built around cases affecting several teeth or the whole mouth.
How does the intake capture treatment timeline for a multi-visit case?
Patients select from as soon as possible, within 1-3 months, within 6 months, or just exploring, so your team can gauge readiness before booking chair time for a case that likely spans multiple appointments.
Turn full-mouth reconstruction visitors into qualified patients
Give every full-mouth reconstruction visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book front-desk time.