Patient Consent with Clincheck

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*

Yes

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

Yes

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

Yes

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*

Yes

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*

Yes

1. 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 traumatized (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*

Yes

2. 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*

Yes

3. 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*

Yes

4. 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*

Yes

Consent

Check all boxes*

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.

Your Name*

Your Email*

Signature*

Patient Consent with Clincheck