As a rule, excellent orthodontic results can be achieved with
informed and co-operative patients. Thus, the following information is routinely
supplied to anyone considering orthodontic treatment in our center. While
recognizing the benefits of a pleasing smile and healthy teeth, you should also
be aware that orthodontic treatment, like any treatment of the body, has some
inherent risks and limitations. These are seldom enough to contra-indicate
treatment, but should be considered in making a decision to start orthodontics.
Please feel free to ask any questions during the treatment.
- The patient’s responsibility:
It is the patient’s responsibility to follow the brushing
and oral hygiene instructions that are given, so that no harm will come to the
teeth and surrounding tissues; to come to all appointments on the proper day
and time; to adhere to the list of food restrictions in order to keep from
damaging the teeth and orthodontic appliance; to wear headgear, elastics and
retainers, if they are necessary, so that treatment time will be as short as
possible and so we can achieve the best results; and to visit the our center
at least every six months for an examination and cleaning. There will be
additional orthodontic charges for replacement of appliances (such as
retainers or braces) that are lost or damaged due to repeated patient neglect,
or any excessive extension of treatment due to lack of patient co-operation.
100% patient co-operation is very, very important.
- Oral hygiene:
Decalcification (permanent markings), decay, or gum disease
can occur if patients do not brush their teeth properly and thoroughly during
treatment period. Excellent oral hygiene and plaque removal is a must. Sugars
and between meal snacks should be reduced as much as possible. Visit our
center or any general dentist regularly or as and when required for general
- A non-vital or dead tooth is a possibility:
A tooth that has been traumatized from a deep filling or
even a minor blow can die over a long period of time with or without
orthodontic treatment. An undetected non-vital tooth may flare up during
orthodontic movement, requiring endodontic (root canal) treatment to maintain
- Root resorption:
In some cases, the root ends of the teeth are shortened
during treatment. This is called root resorption. Under healthy circumstances
the shortened roots are no disadvantage. However, in the event of gum disease
in later life the root resorption may reduce the longevity of the affected
teeth. It should be noted that not all root resorption arises from orthodontic
treatment. Trauma, cuts, impaction, endocrine disorders, idiopathic reasons
can also cause root resorption.
- Growth issues:
Occasionally a person who has grown normally and in average
proportions may not continue to do so. If growth becomes disproportionate, the
jaw relation can be affected and original treatment objectives may have to be compromised. Skeletal growth disharmony is a biologic process beyond the
Dentist’s control. Some orthodontic patients will require oral surgery to obtain a reasonable treatment result to complete their case. Most patients we can inform ahead of time prior to starting any treatment that this is necessary. Some patients with poor growth, poor response to treatment, or poor co-operation may also require oral surgery to complete their cases.
- Gum tissues:
The bone-gum relationship around teeth is always dependent
upon whether there is enough bone to support the gum tissue properly. Many
times when very crowded teeth are straightened there is a lack of bone and
supporting gum tissues surrounding the teeth. Therefore, the gum tissue
contour and support may not be adequate and require periodontal intervention.
- Treatment time:
The total time for treatment can be delayed beyond our
estimate. Lack of, or poorly directed facial growth, poor elastic wear, or
headgear co-operation, broken appliances and missed appointments are all
important factors that could lengthen treatment time and affect the quality of
- Extra-oral appliances:
Instructions must be followed very carefully. A Facebow or
Headgear that is pulled outward while elastic force is attached can cause
damage to the face or eyes. However, we use appliances with a safety feature
to reduce this possibility. Always remember to release the forces before
removing the facebow from your teeth. To reduce the possibility of injury,
contact sports and similar activities should not be performed while a headgear
There is a risk that problems may occur in the
temporomandibular joints (TMJ). Although this is rare, it is a possibility.
Tooth alignment or bite correction sometimes can improve tooth related causes
of TMJ pain, but this is not in all cases. Tension appears to play a role in
the frequency and severity of joint pains, and there are many other causes of
- Very unusual occurrences:
Swallowed appliances, chipped teeth, dislodged restorations
and allergies to latex or nickel rarely occur but are possible.
- Termination of treatment:
It is understood that treatment can be terminated for
failure to cooperate, missing appointments, not wearing appliances, excessive
breakage, failure to keep financial commitments, relocation, personal
conflicts or for any other reason the doctor feels necessary. If termination
is necessary, the patient will be given ample time to locate another
dentist to continue treatment or the braces will be removed.
All orthodontic patients can expect improvement with their
particular problem, but, in many cases, absolute perfection is impossible due
to lack of muscle balance, tooth shapes and sizes and varying degrees of
co-operation during treatment, along with heredity aspects that affects
everyone’s specific treatment results.
Teeth have a tendency to return to their original position
after orthodontic treatment. This is called relapse. Very severe problems have
a higher tendency to relapse and the most common area for relapse is the lower
front teeth. After band removal, a positioner or retainers are placed to
minimize relapse. Full co-operation in wearing these appliances is vital. We
will make our correction to the highest standards and in many cases over
correct in order to accommodate the rebound tendencies. When retention is
discontinued some relapse is still possible.
The mouth is very sensitive so you can expect an adjustment
period and some discomfort due to the introduction of orthodontic appliances.
Non-prescription pain medication can be used during this adjustment period.
Some cases will require the removal of deciduous (baby)
teeth or permanent teeth. There are additional risks associated with the
removal of teeth which you should discuss with us prior to the procedure. The
treatment plan could start with or without extraction ,but during treatment we
should reassess and we might decide to extract one or more than one tooth; the
patient will be informed about the possibility of this point ASAP.
- Orthognathic Surgery:
Some patients have significant skeletal disharmonies which
require orthodontic treatment in conjunction with orthognathic (dentofacial)
surgery. There are additional risks associated with this surgery which you
should discuss with your oral and/or maxillofacial surgeon prior to beginning
orthodontic treatment. Please be aware that orthodontic treatment prior to
orthognathic surgery often only aligns the teeth within the individual dental
arches. Therefore, patients discontinuing orthodontic treatment without
completing the planned surgical procedures may have a malocclusion that is
worse than when they began treatment.
- Nerve Damage
A tooth that has been traumatized by an accident or deep
decay may have experienced damage to the nerve of the tooth. Orthodontic tooth
movement may, in some cases, aggravate this condition. In some cases, root
canal treatment may be necessary. In severe cases, the tooth or teeth may be
- Injury From Orthodontic Appliances:
Activities or foods which could damage, loosen or dislodge
orthodontic appliances need to be avoided. Loosened or damaged orthodontic
appliances can be inhaled or swallowed or could cause other damage to the
patient. You should inform us of any unusual symptoms or of any loose or
broken appliances as soon as they are noticed. Damage to the enamel of a tooth
or to a restoration (crown, bonding, veneer, etc.) is possible when
orthodontic appliances are removed. This problem may be more likely when
esthetic (clear or tooth coloured) appliances have been selected. If damage to
a tooth or restoration occurs, restoration of the involved tooth/teeth by us
may be necessary.
- Non-Ideal Results:
Due to the wide variation in the size and shape of the
teeth, missing teeth, etc., achievement of an ideal result (for example,
complete closure of a space) may not be possible. Restorative dental
treatment, such as esthetic bonding, crowns or bridges or periodontal therapy,
may be indicated. Due to the wide variation in the size and shape of the
teeth, missing teeth, etc., achievement of an ideal result (for example,
complete closure of a space, or typical teeth and jaw midline without
deviation or shifting) may not be possible. Restorative dental treatment, such
as esthetic bonding, crowns or bridges or periodontal therapy, maybe
Occasionally, patients can be allergic to some of the
component materials of their orthodontic appliances. This may require a change
in treatment plan or discontinuance of treatment prior to completion. Although
very uncommon, medical management of dental material allergies maybe
- General Health Problems:
General health problems such as bone, blood or endocrine
disorders, and many prescription and non-prescription drugs (including
bisphosphonates) can affect your orthodontic treatment. It is imperative that
you inform your dentist of any changes in your general health status.
- Use of Tobacco Products:
Smoking or chewing tobacco has been shown to increase the
risk of gum disease and interferes with healing after oral surgery. Tobacco
users are also more prone to oral cancer, gum recession, and delayed tooth
movement during orthodontic treatment. If you use tobacco, you must carefully
consider the possibility of a compromised orthodontic result.
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
dentist(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 dentist(s) indicated below to provide
the treatment. I also authorize the dentist(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 dentist(s), and that treatment
provided by other dental or medical professionals is not included in the fee for
my orthodontic treatment. I hereby consent to the making of diagnostic records,
including x-rays, before, during and following orthodontic treatment and I fully
understand all of the risks associated with the treatment.