TREATMENT RISKS & LIMITATIONS -

Our patients are typically happy with treatment results, but we cannot guarantee complete satisfaction. Orthodontic treatment carries certain risks, including, but not limited to the following:

• Discomfort- Tooth and mouth sensitivity should be expected; Ibuprofen or Tylenol can reduce discomfort.
• Extractions- Deciduous (baby) or permanent teeth may require removal
• Root resorption -Tooth roots may become shortened from unknown causes during treatment.
• Orthognathic surgery- Orthognathic surgery in addition to orthodontics may be recommended for patients with significant skeletal disharmonies. If the patient declines the surgical procedure and discontinues orthodontic treatment, the results may be worse than no treatment at all.
• Treatment time- Facial growth irregularities, failure to follow instructions, tooth movement difficulties, broken appliances, poor oral hygiene, and missed appointments can lengthen treatment time and result in treatment failure.
• Decalcification, decay, gum disease- high sugar diets, non-fluoridated water, and poor oral hygiene can result in cavities, discolored teeth, periodontal disease and/or unsightly decalcification. Uncontrolled gum disease may force discontinuing treatment.
• Nerve Damage – Nerves of teeth traumatized by accidents or deep decay may require root canal treatment or extraction. Orthodontic tooth movement may, in some cases, aggravate this condition.
• Temporomandibular Joint (TMJ) Dysfunction - Joint Dysfunction Problems may occur in the jaw joints, i.e., temporomandibular joints (TMJ), causing pain, headaches or ear problems. Many factors can affect the health of the jaw joints, including past trauma (blows to the head or face), arthritis, hereditary tendency to jaw joint problems, excessive tooth grinding or clenching, poorly balanced bite, and many medical conditions. Jaw joint problems may occur with or without orthodontic treatment. Any jaw joint symptoms, including pain, jaw popping or difficulty opening or closing, should be promptly reported to the orthodontist. Treatment by other medical or dental specialists may be necessary.
• Impacted, Ankylosed, Unerupted teeth- Teeth trapped beneath the gum or not responding normally to orthodontic treatment may require surgical exposure, transplantation, extraction, implant or bridge placement.
• Occlusal adjustment- To help balance your bite and prevent relapse, small amounts of enamel may be removed from your teeth’s biting surfaces.
• Third molars (wisdom teeth)- Third molars may require removal if their eruption interferes with tooth alignment.
• General health issues- Certain medical conditions/medications can affect orthodontic treatment. Tobacco use should be avoided.
• Allergies – Allergies to materials used during orthodontic treatment, though rare, may force us to stop treatment before completion.

I hereby acknowledge that I have read and fully understand the treatment considerations and risks presented in this form. I also understand that there may be other problems that occur less frequently than those presented, and that actual results may differ from the anticipated results. I also acknowledge that I have discussed this form with the undersigned orthodontist(s) and have been given the opportunity to ask any questions. I have been asked to make a choice about my treatment. I hereby consent to the treatment proposed and authorize the orthodontist(s) indicated below to provide the treatment. I also authorize the orthodontist(s) to provide my health care information to my other health care providers. I understand that my treatment fee covers only treatment provided by the orthodontist(s), and that treatment provided by other dental or medical professionals is not included in the fee for my orthodontic treatment.

I have provided my orthodontist with accurate and complete medical and personal history and agree to follow all treatment and post-treatment instructions.