🏠 Home 📋 Mold Kit ✨ Ambassador

Dental Mold Form

Instructions

Click on the teeth below to select which teeth you want gold work done on. Selected teeth will turn gold.

Select Your Teeth

Upper Jaw
15
14
13
12
11
21
22
23
24
25
Lower Jaw
45
44
43
42
41
31
32
33
34
35
None selected

⚠️ HEALTH & SAFETY ACKNOWLEDGMENT

By checking this box, I acknowledge that:

  • I have read and understand the Safety Policy & Health Information
  • Grillz are cosmetic accessories, not medical devices
  • I understand all health risks and care requirements
  • I will consult with a dental professional before wearing grillz
  • I purchase and wear grillz at my own risk
  • All custom grillz sales are final (no returns/exchanges)