Facial Sculpting

Invisalign Consent Form


Patient Consent Form

Orthodontic treatment, like any medical or dental treatment, has some risks. The more common risks of orthodontic treatment include

Gum Problems

1 – Inflammation

  • If you do not keep your teeth and gums clean you will develop gum disease.

  • Gum disease causes inflamed and bleeding gums

  • Gum disease is preventable if you take good care of your teeth and gums.

I understand that I need to remove my Invisalign aligner to clean my teeth  

I understand there is a risk of gum inflammation during orthodontic treatment if I do not clean my teeth  

I understand that I need to brush and floss at least twice a day and ideally after meals  

2 – Recession

  • A less common gum problem that can occur during any type of orthodontic treatment is gum recession.

  • Receding gums causes an exposure of the root of the tooth by loss of gum tissue (see photo).

  • This can happen on any tooth and can be very difficult to predict.

  • Your dentist will inform you if you are at an increased risk of this happening during your treatment.

I understand there is a risk of gum recession during orthodontic treatment  

3 – Black triangles

  • Sometimes when overlapping or very crowded teeth are straightened there is a lack of supporting gum tissue surrounding the teeth.

  • This may cause the appearance of a “black triangle”.

I understand there is a risk of black triangles occurring during orthodontic treatment  

Root Resorption

  • This is shortening of the roots of the teeth.

  • Mild resorption is common with all types of braces.

  • Severe resorption is uncommon but can occur if teeth have previously been traumatised (damaged by accident) or had previous braces.

  • However It can happen without any known cause.

  • Even with severe resorption, prognosis can be good in the medium to long term.

I understand there is a risk of root resorption during orthodontic treatment  

Relapse after orthodontic treatment

  • Teeth will want to move back to their original position after orthodontic treatment. This is called relapse.

  • Relapse can be prevented by wearing a retainer.

  • It is important to follow the instructions given to you by your dentist when treatment is complete in order to reduce the risk of relapse.

  • You must wear your removable retainer for a minimum of 6 months following treatment and every night thereafter.

  • If you lose or break this retainer you must have a replacement made immediately or there is a risk your teeth could move. You will incur the cost of the replacement retainer.

I understand there is a risk of relapse after orthodontic treatment if I do not wear my retainer as advised by my dentist  

A Non-Vital Tooth

  • A non vital tooth means the nerve in the tooth has died.

  • Certain teeth are at a higher risk of becoming non vital during orthodontic treatment. For example, teeth which have already had a root canal treatment or teeth which have had accidents.

  • An undetected non vital tooth may flare up during orthodontic treatment, requiring root canal treatment to maintain it.

I understand that during orthodontic treatment a tooth may become non vital and require root canal treatment  

Length of Treatment

  • Your dentist will give you an estimate of how long they think your treatment will last.
  • It is important to remember that this is just an estimate.
  • There are some factors which will affect how long your brace treatment will last including

Missed Appointments

  • It is important to attend for your appointments every 4-8 weeks as instructed by your orthodontist.
  • If you miss any appointments, your treatment will take longer.
  • Unsupervised treatment will also increase the risk root resorption and periodontal disease.

Poor Compliance

  • Aligners must be worn at all times.
  • Under no circumstances should you take them out for over 90mins at any one time

Genetics

  • How quick teeth move is different from person to person.
  • For some people, their teeth move quicker than average and so their treatment will not take as long as initially thought.
  • For others, treatment may take longer if their teeth are slow to move.

I have seen the 3D movement of my teeth on the computer called ‘Clincheck’ and I am happy that my concerns are being addressed  

I have been given adequate time to read the above consent document.

I understand the benefits and risks associated with this treatment.

I have had the opportunity to ask questions and discuss any concerns I have regarding the treatment.

Date:  

Leave this empty:

Signed by Nina Bal
Signed On: 8th January 2020

Signature Certificate
Document name: Invisalign Consent Form
Unique Document ID: 3ce8fd754bb9be30fd786e0cb1acfc59b6a7a793
Timestamp Audit
7th November 2019 2:50 pm BSTInvisalign Consent Form Uploaded by Nina Bal - info@facialsculpting.co.uk IP 51.179.98.227