Braces Consent Form

ORTHODONTIC INFORMATION AND CONSENT FORM

As a rule, positive orthodontic results can be achieved by informed and cooperative patients. Thus the following information is routinely supplied to all who consider orthodontic treatment. While recognising the benefits of healthy teeth and a pleasing smile, you should also be aware that orthodontic treatment has limitations and potential risks. These are seldom enough to avoid treatment, but should be considered in making the decision to undergo orthodontic treatment. Orthodontic treatment usually proceeds as planned; however, like all areas of the healing arts, response to treatment and results cannot be guaranteed. The success of treatment depends on your co-operation in keeping appointments, maintaining good oral hygiene, avoiding loose or broken appliances, and following the dentist's instructions carefully.

Orthodontics plays an important role in improving overall oral health. Orthodontics strives to improve the bite by helping to direct forces placed on the teeth. This protects the teeth from trauma during ordinary everyday activities, such as chewing stress. Properly aligned teeth also help minimize excessive stress on bones, roots, gum tissues and the temporomandibular joints. Orthodontic treatment has the potential to eliminate future dental problems, including the problem of abnormal wear. Treatment can facilitate good oral hygiene to minimize decay and future periodontal problems. Properly aligned teeth are easier to brush, and thereby may decrease the tendency to decay, or to develop diseases of the gum and supporting bone. Orthodontics also helps create balance and harmony between the teeth and face for a beautiful, healthy smile. An attractive smile enhances one’s self esteem, which may actually improve the quality of life itself. Due to individual conditions present and the limitations of treatment imposed by nature, each specific benefit may not be attainable for every patient. The unknown factor in any orthodontic correction is the treatment response and cooperation of the patient during orthodontic treatment.

All forms of medical and dental treatment, including orthodontics, have some risks and limitations. Fortunately, in orthodontics complications are infrequent and when they do occur they are usually of minor consequence.Nevertheless, they should be considered when making the decision to undergo orthodontic treatment. The major risks involved in orthodontic treatment may include, but are not limited to:

Decalcification & Dental Caries
Excellent oral hygiene is essential during orthodontic treatment as are regular dental checkups. Inadequate or improper hygiene could result in cavities, discolored teeth, periodontal disease and/or decalcification (permanent enamel markings). These same problems can occur without orthodontic treatment, but the risk is greater to an individual wearing braces or other appliances. These problems may be aggravated if the patient has not had the benefit of fluoridated water or its substitute, or if the patient consumes sweetened beverages or foods.

Root Resorption
The roots of some patients’ teeth become shorter (resorption) during orthodontic treatment. It is not known exactly what causes root resorption, nor is it possible to predict which patients will experience it. However, many patients have retained teeth throughout life with severely shortened roots. If resorption is detected during orthodontic treatment, your dentist may recommend a pause in treatment or the removal of the appliances prior to completion of orthodontic treatment.

Relapse
Completed orthodontic treatment does not guarantee perfectly straight teeth for the rest of your life. Retainers will be required to keep your teeth in their new positions as a result of your orthodontic treatment. You must wear your retainers as instructed or teeth may shift, in addition to other adverse effects. Regular retainer wear is often necessary for several years following orthodontic treatment. However, changes after the time can occur due to natural causes, including habits such as tongue thrusting, mouth breathing, and growth and maturation that continue throughout life. Later in life, most people will see their teeth shift. Minor irregularities, particularly in the lower front teeth, may have to be accepted. Some changes may require additional orthodontic treatment, or in some cases, surgery. Some situations may require non-removable retainers or other dental appliances.

Temporomandibular (TMJ) Joint Dysfunction
Problems may occur in the jaw joints, i.e., temporomandibular joints (TMJ), causing pain, headaches or ear problems. Many factors can affect the health of the jaw joints, including past trauma (blows to the head or face), arthritis, hereditary tendency to jaw joint problems, excessive tooth grinding or clenching, poorly balanced bite, and many medical conditions. Jaw joint problems may occur with or without orthodontic treatment. Any jaw joint symptoms, including pain, jaw popping or difficulty opening or closing, should be promptly reported to the dentist. Treatment by other medical or dental specialists may be necessary.

Loss of Tooth Vitality
A tooth that has been traumatized by an accident or deep decay may have experienced damage to the nerve of the tooth. Orthodontic tooth movement may, in some cases, aggravate this condition. In some cases, root canal treatment may be necessary. In severe cases, the tooth or teeth may be lost.

Injury from Orthodontic Appliances
Activities or foods which could damage, loosen or dislodge orthodontic appliances need to be avoided. Loosened or damaged orthodontic appliances can be inhaled or swallowed or could cause other damage to the patient. You should inform your dentist of any unusual symptoms or of any loose or broken appliances as soon as they are noticed. Damage to the enamel of a tooth or to a restoration (crown, bonding, veneer, etc) is possible when orthodontic appliances are removed. If damage to a tooth or restoration occurs, restoration of the involved tooth/teeth by your dentist may be necessary.

Injury during Orthodontic Treatment
On rare occasions, when dental instruments are used in the mouth, the patient may inadvertently get scratched, enamel abrasions, poled or received a blow to a tooth with potential damage to or soreness of affected oral structures. We will use extreme care of avoid minor injuries.

Headgear (If headgear is necessary)
Orthodontic headgears can cause injury to the patient. Injuries can include damage to the face or eyes. in the event of injury or especially an eye injury, however minor, immediate medical help should be sought. Refrain from wearing headgear in situations where there may be a chance that is could be dislodged or pulled off. Sports activities and games should be avoided when wearing orthodontic headgear. Although our headgears are equipped with a safety system, we urge caution at all times.

Periodontal Disease
Periodontal (gum and bone) disease can develop or worsen during orthodontic treatment due to many factors, but most often due to lack of adequate oral hygiene. In general, orthodontic treatment lessens the possibility of tooth loss or gum infection due to correction of misalignment of the teeth or jaws. Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed daily with good oral hygiene. You must have your hygienist monitor your periodontal health during orthodontic treatment every three to six months. If periodontal problems cannot be controlled, orthodontic treatment may have to be discontinued prior
to completion.

Impacted, Ankylosed, Unerupted Teeth
Teeth may become impacted (trapped below the bone or gums), ankylosed (fused to the bone) or just fail to erupt. Oftentimes, these conditions occur for no apparent reason and generally cannot be anticipated. Treatment of these conditions depends on the particular circumstance and the overall importance of the involved tooth, and may require extraction, surgical exposure, surgical transplantation or prosthetic replacement.

Occlusal Adjustment
You can expect minimal imperfections in the way your teeth meet following the end of treatment. An occlusal equilibrium procedure may be necessary, which is a grinding method used to fine-tune the occlusion. It may also be necessary to remove a small amount of enamel in between the teeth, thereby ‘flattening’ surfaces in order to reduce the possibility of a relapse.

Extractions
Some cases will require the removal of deciduous (baby) teeth or permanent teeth. There are additional risks associated with the removal of teeth which you should discuss with the dentist or oral surgeon prior to the procedure.

Third Molars
As third molars (wisdom teeth) develop, your teeth may change alignment. Your dentist should monitor them in order to determine when and if the third molars need to be removed.

In dealing with human beings and problems of growth and development, genetics and patient cooperation, achieving perfection is not always possible. Orthodontics is an art, not an exact science; therefore, a functionally and aesthetically adequate result, not 100% perfection, must be acceptable. Your comments in regard to your expectations prior to, during and after orthodontic treatment will help us understand your concerns. Please keep us regularly informed of your feelings, concerns and results that do not meet your expectations.

The mouth may become very sensitive so you can expect an adjustment period and some discomfort due to the introduction of orthodontic appliances. Non-prescription pain medication can be used during the adjustment period. Periodic adjustments may be required after initial placement of orthodontic appliances, which may cause some tenderness/discomfort. Typically, post- adjustment tenderness may last 24-48 hours. Sometimes orthodontic appliances may accidentally be swallowed or aspirated or may irritate or damage oral tissues. The gums, cheeks and lips may be scratched or irritated by loose or broken appliances or by traumatic blows to the mouth. You should inform our surgery of any unusual symptoms, broken or loose appliances, as soon as they are noted.

Estimated Length of Treatment
The length of treatment depends on a number of issues, including the severity of the problem, the patient’s growth and the level of patient co-operation. The actual treatment time is usually close to the estimated treatment time, but treatment may be lengthened if, for example, unanticipated growth occurs, if there are habits affecting the dentofacial structures, if periodontal or other dental problems occur, or if patient cooperation is not adequate. Therefore, changes in the original treatment plan may become necessary. If treatment time is extended beyond the original estimate, additional fees may be applicable.

Possible Alternative Treatments
For the vast majority of patients, orthodontic treatment is an elective procedure. One possible alternative to orthodontic treatment is no treatment at all. You could choose to accept your present oral condition. The specific alternative to the orthodontic treatment of any particular patient depends on the nature of the individual’s teeth, supporting structures and appearance. Alternatives could include:

• Extraction versus treatment without extraction(s)
• Orthodontic surgery versus treatment without orthodontic surgery
• Possible prosthetic solutions (bridges, implants, partials, replacement teeth and
• Possible comprised approaches (To be discussed with you, if applicable)