Braces - Informed Consent to Fixed Orthodontic Treatment

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Orthodontic Treatment

Orthodontic treatment promotes a healthy smile, healthier teeth and gums and a better bite for normal chewing. Orthodontic treatment depends for much of its success on the understanding and cooperation of the patient. This form covers the usual material risks associated with orthodontic treatment. Other factors may also be described by your orthodontist. You may ask your orthodontist to explain anything you do not understand. While recognising the benefits of healthy teeth and a pleasing smile, you should also be aware that orthodontic treatment has limitations and potential risks and there may be alternative treatment options. You should clarify what is expected of you as a patient, or as the parent of a young patient, to achieve excellent results. Keep in mind that with orthodontic treatment, like other healing arts, results cannot be guaranteed. The unknown factor in any orthodontic correction is the response of the patient to the orthodontic treatment. Should you have any questions, please ask.

Benefits

Orthodontics plays an important role in improving overall oral health and achieving balance and harmony between the face and teeth for a healthy smile, which may enhance one’s self esteem. The correct bite of the teeth with healthy muscles and jaw joints will provide optimal chewing function. Properly aligned teeth are easier to brush so the tendency to decay may decrease, as may the likelihood of developing disease of the gums and supporting bone. Correctly aligned teeth are less likely to experience abnormal wear.

Because of the individual conditions present and the limitations of treatment imposed by nature each specific benefit may not be attainable for every patient.

Risks

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 only minor consequence. Nevertheless, they should be considered when making the decision to undergo orthodontic treatment. The principal risks in orthodontic treatment pertained to:

1. Oral hygiene
Orthodontic appliances do not cause tooth decay. Gum disease, tooth decay and permanent markings (decalcification) on the teeth can occur if orthodontic patients eat food containing excessive sugar or do not brush their teeth frequently or properly. These same problems can occur without orthodontic treatment, but the risk is greater to an individual wearing braces. It is imperative during orthodontic treatment that extra care can be taken with oral hygiene and tooth-brushing in particular.

2. Relapse
Teeth may have the tendency to change their position after treatment. The long term, faithful wearing of retainers should reduce this tendency. Teeth can however, move any time, whether or not they have had orthodontic treatment. This is especially true during the late teeth period when active growth of the facial bones is coming to an end. The most vulnerable teeth are those at the front. Throughout life the bite can change adversely from various causes such as eruption of wisdom teeth, growth or maturation changes, mouth breathing, playing of musical instruments and other oral habits. Very occasionally tooth movements will be severe enough to merit a future course of treatment to ensure a satisfactory result.

3. Periodontal health
The health of the bone and gums which support the teeth may be affected by orthodontic tooth movement if a condition already exists, and in some rare cases where a condition does not appear to exist. In general, orthodontic treatment lessens the possibility of tooth loss, or gum infection due to 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.

4. Root shortening
In some patients the length of the roots of the teeth may be shortened during orthodontic treatment. Some patients are prone to this happening, some are not. It is nearly impossible to predict susceptibility. Usually this shortening does not have significant consequences, but on very rare occasions it may become a threat to the longevity of the teeth involved.

5. Jaw joints
Occasionally patients may suffer pain or dysfunction in the jaw joints (TMJ). This may present as joint pain, headaches or ear problems. These problems may occur with or without orthodontic treatment. Any of the above noted symptoms should be reported to the orthodontist. Some patients are susceptible to TMJ problems and some are not. Numerous studies have shown that the movement of the teeth during orthodontic treatment is not unrelated to the onset of TMJ problems. Just as the painful conditions in the other joints, discomfort in TMJ can last from a few days to several weeks or longer.

6. Tooth vitality
Sometimes a tooth may have been traumatised by a previous accident or a tooth may have decayed or have fillings which can cause damage to the nerve of the tooth. Orthodontic tooth movement in some cases aggravates these conditions and in rare instances may lead to loss of tooth vitality and discolouration of the tooth requiring root canal treatment and other dental treatment to restore the colour of the tooth.

7. Loose appliances and discomfort
The gums, cheeks or lips may be scratched or irritated by newly placed appliances or by loss of broken appliances or by blows to the mouth. You will be given instructions on minimising these effects. Very rarely, loose orthodontic appliances may be accidentally swallowed or aspirated. You should inform your orthodontist of any unusual symptoms, or broken or loose appliances, as soon as they are noted. Usual post adjustment tenderness should be expected and the period of tenderness or sensitivity varies with each patient and the procedure performed (typical post adjustment tenderness may last 24 to 48 hours).

8. Atypical growth
Insufficient, excessive or asymmetrical changes in the growth of the jaws may limit the orthodontist’s ability to achieve the desired result. If growth becomes disproportionate during orthodontic management, the treatment may be prolonged. Growth changes that occur after orthodontic treatment may alter the quality of treatment results and may require further orthodontic treatment. In some cases of atypical growth, the bite may change so much that oral surgery is required to achieve the best possible result.

9. Headgear
If improperly handled, headgear may cause injury to the face. Patients are warned not to wear the appliance during times of boisterous or competitive activity.

10. Treatment time
The total time required to complete treatment may exceed the estimate. Poor cooperation in wearing the appliance or the elastic for the required hours per day, poor oral hygiene, broken appliances and missed appointments can lengthen the treatment time and affect the quality of results.

11. Cooperation
Co-operation throughout treatment is your best guarantee of achieving a pleasing smile and a good bite. Failure to cooperate could force the orthodontist to change the procedures and goals of your treatment. As a last resort, treatment might have to be suspended. The consequences of early suspension may be worse than no treatment at all.

12. Complementary aesthetic dentistry
If your teeth vary from normal in the number size or shape of the teeth, achievement of the ideal result (e.g. complete closure of excessive space) may require restorative treatment. The most common types of complementary treatment are cosmetic bonding, crown and bridge restorative dental and periodontal therapy.

13. General health
General medical problems can affect orthodontic treatment. You should keep your orthodontist informed of any changes to your medical health.

14. Interproximal Reduction (IPR)
Some minor cosmetic reshaping, polishing or IPR might be performed to improve the result cosmetically and to achieve a better bite. Although this procedure is done very carefully, there is an increased risk of tooth sensitivity, decay and/or gum complications if oral hygiene is not satisfactory.

Consent to Treatment

I hereby authorise Dr Sep Tabatabaee to carry out orthodontic treatment and any other related procedures deemed necessary including radiographs, for the welfare and treatment of

I have had the proposed treatment plan explained to me along with the risks of orthodontic treatment explained to me, and been given a document that outlines these risks.

I confirm that the risks attached to the proposed treatment have been explained to me by my practitioner and that I fully understand those risks and have determined to proceed with treatment.

I will make every effort to attend appointments, and wear the orthodontic appliances as instructed.

I understand that any more than 3 attendance failures to appointments without at least 48 hours’ notice will incur a no-show fee of $70.

Financial Agreement

I agree to pay the fees for treatment, as outlined below:

Payment plan:

I agree to follow all of Wired Orthodontics policies and procedures and acknowledge that these will change from time to time.

I agree to the use of the records obtained by the orthodontist including photographic and X-rays images, and orthodontic models for demonstration, display or social media.

Some minor cosmetic reshaping/polishing might be performed to improve the result cosmetically.

I understand that the orthodontist does not do fillings or other general dental work. I will continue to attend for regular dental examinations, and treatment as required during the course of the orthodontic treatment.

I understand that retainers follow my orthodontic treatment. Failure to wear these as prescribed may lead to tooth movement. Fees could apply if re-treatment is needed to correct this. I understand that the fees cover 2 years of retainer visits; if the retainer is lost or broken a fee for the new retainer will be charged.

I acknowledge that orthodontic appliances will not be removed if there is an outstanding account

I acknowledge that late fees will be incurred on overdue invoices, our invoices are 30-day invoices. To avoid a late payment fee of $15 please pay new charges by the due date.

By submitting this form, you are agreeing to our privacy policy.

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Wired Orthodontics
1359 Sandgate Road
Nundah QLD 4012
Free parking available

07 3260 6855

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