Orthodontic Treatment Consent

3/5 Murdoch Dr, Greenfields WA 6210

Phone: (08) 9586 9653

Email: [email protected]

www.morethanasmile.com.au

Orthodontic Treatment

Orthodontic treatment promotes a healthy smile by improving the way the teeth and jaws function. Successful orthodontic treatment relies on the cooperation and understanding of the patient. This form covers theusual risks associated with orthodontic treatment. Other factors may also have been discussed by your orthodontist.Please ask your orthodontist to explain anything that you do not understand.

While recognising the benefits of healthy teeth and a pleasing smile, you should also be aware that orthodontictreatment has limitations and potential risks. Biological factors and patient cooperation can adversely influence yourtreatment.

BenefitsProperly aligned teeth improve oral health making the teeth easier to brush and reducing the risk of decay and thelikelihood of developing gum disease. Well-aligned teeth are less likely to experience abnormal wearing down of teethand may enhance a person’s self-esteem with a healthy, beautiful smile.

RisksAll forms of medical and dental treatment have some risks and limitations. Fortunately, orthodontic risks areinfrequent. Nevertheless, they should be considered when deciding to undergo orthodontic treatment. The principalrisks in orthodontic treatment pertain to:

1: Oral HygieneOrthodontic appliances do not cause tooth decay. Gum disease, tooth decay and permanent markings (decalcification)on the teeth can occur if patients eat food containing excessive sugar or do not brush their teeth frequently orproperly.

It is imperative during treatment that extra care be taken with oral hygiene and continue to see your general dentistfor your regular check-ups and scale and polish throughout treatment.

2: Periodontal HealthThe health of the bone and gums which support the teeth may be affected by orthodontic tooth movement and willcontinually be monitored by your orthodontist. Inflammation of the gums and loss of supporting bone can occur ifbacterial plaque is not removed daily with good oral hygiene.

3: Recession and Gum GraftingMoving teeth with inadequate gum tissue can lead to gum recession during or after braces. To prevent this, it may berecommended to have some teeth extracted or gum grafting may be recommended with a specialist.

4: Root ShorteningAny orthodontic treatment can increase the risk of root resorption. Some people are prone to this happening, someare not. Previous trauma and habits, such as grinding your teeth, nail-biting or smoking may increase the risk of rootshortening. Usually, this does not have significant consequences, but on rare occasions, it may compromise thelongevity of the tooth involved.

5: Tooth VitalityPrevious trauma, restorations or underlying issues may increase the risk of nerve damage. Orthodontic toothmovement in some cases aggravates this condition and in rare instances may lead to loss of tooth vitality anddiscolouration (requiring root canal treatment).

6: Ankylosis (Tooth root fused to bone)An ankylosed tooth means the root is permanently connected to the jaw bone and cannot be moved orthodontically. In some instances, it may not be obvious that the root has fused until treatment on the tooth is unsuccessful. Inthese rare instances, your orthodontist will discuss an alternative treatment option with you.

7: Atypical Growth/Accepting Skeletal DiscrepancyInsufficient, excessive or asymmetrical changes in the growth of jaws may limit the orthodontist’s ability to achievethe desired result. Growth changes that occur after orthodontic treatment may alter the bite, so much so that oralsurgery is required to achieve the best possible result. Without surgical correction, you are accepting the position of your jaw, facial profile, any skeletal or soft tissuediscrepancies, including uneven midlines. Your overbite, underbite or protrusion may not be fully corrected withoutjaw surgery and you are accepting a “compromised” result to improve but not fully correct these concerns.

8: Jaw Joint Issues Occasionally patients may suffer pain or dysfunction in the jaw joints (TMJ). This may present as jaw joint pain,clicking or difficulty chewing. Some patients are susceptible to TMJ issues. While orthodontic treatment may havelittle or no effect on jaw joint issues, please let your orthodontist know if you notice a difference in this condition.

9: Aesthetic Dentistry If you have missing teeth or teeth that vary in size or shape, this may affect achieving an ideal result using onlyorthodontics and may require additional cosmetic dentistry to achieve the desired result. This may include cosmeticbuild-ups of small teeth to close spaces or dental implants or bridges for missing teeth. Cosmetic dentistry should becompleted by an appropriate specialist after your orthodontic treatment.

10: IPR - Interproximal ReductionYou may need some reshaping or slenderization of teeth during your treatment with your orthodontist if you havelarge or misshaped teeth. Teeth may temporarily feel sensitive.

11: “Black Gummy Triangles”Triangular shaped teeth or gum recession may lead to “Black Triangles” which are small spaces that can form in betweenyour teeth and Inter-proximal during orthodontic treatment. These spaces can sometimes be minimised with IPR (Inter-proximal Reduction) or through cosmetic dentistry with build-ups after orthodontic treatment if you wish.

12: Previously Restored TeethRestorations to teeth may be damaged during your orthodontic treatment and may need replacing by your generaldentist when treatment is complete.

13: Loose Appliance and DiscomfortNew appliances can take a little getting used to. The gums, cheeks or lips may be scratched or irritated by new, loose orbroken appliances. You will be given instructions on minimising these effects. You should inform your orthodontist ofany unusual symptoms or broken or loose appliances as soon as possible for advice.

14: HeadgearIf improperly worn or handled, the headgear may cause injury to the face. Patients are warned not to wear the applianceduring times of horseplay or competitive activity.

15: Treatment Time and ComplianceThe treatment time given by your orthodontist is an estimate and may exceed the proposed time.Poor co-operation in wearing the appliance or elastics, poor oral hygiene, broken brackets or appliances, missedappointments can all lengthen the treatment time and quality of the results.Poor compliance may result in a change to the goals of your treatment and may incur additional costs. As a last resort,treatment might have to be suspended.

16: RelapseTooth movement is a natural part of the ageing process. The long term wearing of retainers should reduce this tendency. It is generally advised to wear your retainers every night after a period of full-time wear following full orthodontictreatment. Retainers are removable or in some instances, a bonded retainer may be advised. Retainers will not last alifetime and will require replacing if lost, broken or worn. Replacements will incur additional costs.

17: General HealthGeneral medical problems can affect orthodontic treatment. Please keep your orthodontist informed of any changes toyour medical health.

I acknowledge that the major treatment considerations and potential risks of orthodontic treatment have beenpresented to me. I have read and understood this form and that there may be other problems that occur less frequentlyor are less severe which may affect anticipated results. I have read and fully understand the content of this form andhave been allowed to ask any questions.

Patient Name: …………………………………………………………………………………

Patient/Parent/Guardian Signature ………………………….……………………………….…..… Date……………..………………

PLEASE READ, SIGN AND RETURN THIS FORM PRIOR TO COMMENCING TREATMENT