Debond Consent For Aligners

This is to certify that I am satisfied with the outcome of my orthodontic treatment and consent for the removal of attachments. I have been provided with removable retainers to maintain the position of my teeth following the completion of my orthodontic treatment.
I commit to maintaining proper oral hygiene at home, including thorough brushing and flossing techniques. I also understand that regular examinations and cleanings with a dentist are essential for my long-term oral health.

Patient Agreement and Informed Consent – Retainers

Upon the removal of my active orthodontic appliances, I will receive a set of clear, removable retainers to maintain my dental correction. I acknowledge and understand the following
responsibilities:

Retainer Wear Instructions:

• Wear the clear retainers day and night for the first month following treatment, then transition to night-only wear.
• Attend recall appointments at 3, 6, and 12 months to monitor the retainers'; effectiveness.
• Continued retainer wear is essential even after the monitoring period to prevent tooth movement.
• In rare cases, teeth may shift slightly despite wearing retainers at night. To minimize this risk, it is recommended to consider a fixed wire retainer behind the upper and lower front teeth.

How to Care for Retainers:

• Keep retainers away from excessive heat to prevent warping.
• Always store retainers in the provided case when not in use.
• Ensure retainers are kept out of reach of family pets, as they can easily be damaged.
• Use a regular sports mouthguard during physical activities; do not wear retainers during sports.
• Remove retainers when eating or drinking anything other than water to avoid damage or discoloration.
• Clean retainers daily using a toothbrush and mild liquid soap, avoiding toothpaste or denture cleaners which can cause abrasions.

Responsibility for Replacement:

• I understand that retainers may require periodic replacement. The original treatment contract covers one set of retainers.
• Lost or damaged retainers due to neglect or misuse will incur a replacement fee.
• Failure to wear retainers as directed can result in teeth shifting, which may require further orthodontic treatment.
• If I notice any discomfort or fit issues with the retainers, I will promptly notify my orthodontist for evaluation.