Braces Informed Consent to Fixed Orthodontic Treatment

Orthodontic treatment promotes a healthy smile, healthier teeth and gums, and a better bite. Much of its success depends on the understanding and cooperation of the patient. This form covers the usual material risks associated with orthodontic treatment.

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.

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 of orthodontic treatment

Orthodontics is vital for enhancing overall oral health and creating harmony between the face and teeth, which can boost self-esteem. A correct bite, along with healthy muscles and jaw joints, ensures optimal chewing function.

Well-aligned teeth are also easier to clean, which can reduce the risk of decay and gum disease, as well as prevent abnormal wear.

However, due to individual variations and natural limitations, not every patient may achieve all of these benefits.

Risks of 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 only minor consequence.

1. Oral hygiene

Orthodontic appliances themselves do not cause tooth decay. However, issues like gum disease, tooth decay, and permanent markings (decalcification) can arise if orthodontic patients consume excessive sugar or do not brush their teeth regularly and thoroughly.

While these problems can occur even without orthodontic treatment, the risk is higher for those with braces. Therefore, maintaining excellent oral hygiene and diligent tooth brushing is crucial during orthodontic treatment.

2. Relapse

Teeth can shift position after orthodontic treatment, but consistent and long-term use of retainers can help minimise this tendency. Movement can occur at any time, whether or not orthodontic treatment was received, and is particularly common during late adolescence when facial bone growth slows. Front teeth are especially susceptible.

Throughout life, factors such as the eruption of wisdom teeth, growth or maturation changes, mouth breathing, playing musical instruments, and other oral habits can negatively affect the bite. In rare cases, significant tooth movement may require further treatment to achieve a satisfactory result.

3. Periodontal health

Orthodontic tooth movement can impact the health of the bone and gums supporting the teeth, especially if an existing condition is present, and occasionally even when no condition is apparent.

Generally, orthodontic treatment reduces the risk of tooth loss or gum infections caused by misalignment of the teeth or jaws. However, if bacterial plaque is not removed daily through proper oral hygiene, it can lead to gum inflammation and loss of supporting bone.

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 experience pain or dysfunction in the jaw joints (TMJ), which can manifest as joint pain, headaches, or ear issues. These problems can arise with or without orthodontic treatment.

It is important to report any of these symptoms to the orthodontist. While some patients are more prone to TMJ issues than others, research has indicated that tooth movement during orthodontic treatment can be associated with the onset of TMJ problems.

6. Tooth vitality

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

Newly placed orthodontic appliances or damage to existing appliances can occasionally cause irritation or scratches to the gums, cheeks, or lips, especially if impacted by accidental blows to the mouth. You will receive guidance on how to minimise these effects. In rare cases, loose orthodontic appliances may be accidentally swallowed or inhaled.

If you notice any unusual symptoms or find that an appliance is broken or loose, you should inform your orthodontist immediately. Some tenderness after adjustments is normal and typically lasts between 24 to 48 hours, though the duration can vary depending on the patient and the specific procedure performed.

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

Cooperation 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, crowns, 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.

15. Damage to existing crowns or restorations

Orthodontic treatment may compromise the integrity of existing dental crowns or restorations, potentially causing damage or breakage, necessitating their repair or replacement.

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:

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.