Consent to Treatment Form
Orthodontic treatment promotes a healthy smile, healthier teeth and gums, and a better bite for normal chewing. Much of its success depends on the patient’s understanding and co-operation. 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 recognizing the benefits of healthy teeth and a pleasing smile, you should also be aware that orthodontic treatment has limitations and potential risks, and that 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, like other healing arts, orthodontic treatment cannot guarantee results. The unknown factor in any orthodontic correction is the patient’s response to the 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, contributing to a healthy smile that may enhance self-esteem. A correct bite, with healthy muscles and jaw joints, provides optimal chewing function. Properly aligned teeth are easier to brush, reducing the risk of decay and the likelihood of developing gum and supporting bone disease. Correctly aligned teeth are less likely to experience abnormal wear. Because of individual conditions 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, carry risks and limitations. Fortunately, in orthodontics, complications are infrequent and, when they do occur, are usually minor. Nevertheless, they should be considered when deciding to undergo orthodontic treatment. The principal risks in orthodontic treatment pertain to:
1: Oral Hygiene
Orthodontic appliances do not cause tooth decay. Gum disease, tooth decay, and permanent tooth markings (decalcification) can occur if orthodontic patients eat sugary foods or do not brush their teeth regularly and properly. These same problems can occur without orthodontic treatment, but the risk is greater for an individual wearing braces. It is imperative during orthodontic treatment that extra care be taken with oral hygiene, particularly tooth brushing.
2: Relapse
Teeth may tend to shift their positions after treatment. Long-term, faithful wearing of retainers should reduce this tendency. Teeth can, however, move at any time, whether or not they have had orthodontic treatment. This is especially true during the late teenage years, 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 for various reasons, such as the eruption of wisdom teeth, growth or maturational changes, mouth breathing, playing musical instruments, and other oral habits. Very occasionally, tooth movements will be severe enough to warrant a further course of treatment to ensure a satisfactory result.
3: Periodontal Health
The health of the bones and gums that support the teeth may be affected by orthodontic tooth movement if a condition already exists, and in some rare cases, even when no condition appears to exist. In general, orthodontic treatment reduces the risk of tooth loss or gum infections caused by misaligned teeth or jaws. Inflammation of the gums and loss of supporting bone can occur if bacterial plaque is not removed daily through 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, while others are not. It is nearly impossible to predict susceptibility. Usually, this shortening does not have significant consequences, but on very rare occasions, it may threaten the longevity of the teeth involved.
5: Jaw Joints
Occasionally, patients may experience 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 symptoms should be reported to the orthodontist. Some patients are susceptible to TMJ problems, while others are not. Numerous studies have shown that tooth movement during orthodontic treatment is unrelated to the onset of TMJ problems. As with painful conditions in other joints, TMJ discomfort 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 it may be decayed or have fillings, which can damage the tooth's nerve. In some cases, orthodontic tooth movement aggravates this condition 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, loose or 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 of any 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 jaw growth may limit the orthodontist’s ability to achieve the desired result. If growth becomes disproportionate during orthodontic management, 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 facial injury. Patients are warned not to wear the appliance during boisterous or competitive activity.
10: Treatment Time
The total time required to complete treatment may exceed the estimate. Poor co-operation with wearing the appliance or elastics for the required hours per day, poor oral hygiene, broken appliances, and missed appointments can lengthen the treatment time and affect the quality of the results.
11: Co-operation
Co-operation throughout treatment is your best guarantee of achieving a pleasing smile and a good bite. Failure to co-operate may require 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 number, size or shape, achieving the ideal result (for example, complete closure of excessive space) may require restorative treatment. The most common types of complementary treatment are cosmetic bonding, crown and bridge restorative dental care and periodontal therapy.
13: General Health
General medical problems can affect orthodontic treatment. You should keep your orthodontist informed of any changes to your health.
14: Heidi Consent
We use a secure, AI-powered note-taking tool, Heidi, to accurately document your consultation, so we can focus more on your care. All information is handled confidentially and used only to support your treatment. For more information, please visit heidihealth.com. By signing below, you consent to the use of Heidi during your appointment.
15: Consent for Radiographic Imaging
The patient has been informed of the need for radiographs (X-rays) and consents to imaging being taken if required.
Consent to Treatment
I hereby authorise Dr Sean O'Callaghan to carry out orthodontic treatment and any other related procedures deemed necessary, including radiographs, for the patient's welfare and treatment.
Confirmation
I confirm that my practitioner has explained the risks associated with the proposed treatment to me, that I fully understand those risks, and that I have decided to proceed with treatment.
