• Orthodontics Informed Consent Agreement

  • I consent to the orthodontic treatment recommended by and explained to me by Dr. Bao Nguyen. I fully understand that, during orthodontic treatment and retention, certain conditions may limit treatment success. Also, certain complications occasionally may occur during the orthodontic treatment and retention period. These may include:

    1. Oral discomfort such as swelling of the gums and inside the check area.

    2. Tooth decay and tooth decalcification (white chalky discolouration of the teeth).

    3. Periodontal (gum) disease and gingival attachment levels.

    4. Tooth mobility.

    5. Root resorption.

    6. Loss of tooth vitality.

    7. Tooth attrition.

    8. Temporomandibular joint noises, popping or pain.

    9. Facial changes.

    10. Speech problems.

    11. Difficulty with musical instruments.

    12. Injuries during orthodontic treatment. Possible swallowing or inhaling appliances. Injuries resulting from patient abuse of removable appliances such as headgear accidents.

    13. Unfavourable jaw growth. Skeletal shape, dental positioning or facial characteristics that may limit the effectiveness of orthodontic treatment.

    14. Atypical teeth or missing teeth.

    15. Ankylosed teeth.

    16. Impacted teeth.

    17. Allergies

    18. Post-treatment changes of tooth and / or jaw positions.

    19. Psychological aspects.

    20. Orthognathic surgery risks such as infection, improper healing, reaction to general anaesthetic, loss of feeling around mouth or teeth and shifting or relapse of jaw bone position.

     

    Various treatment methods have been completely explained to me. As set forth by Dr. Nguyen, I am in agreement with the selected method of treatment.

    I understand that, for a successful orthodontic and to reduce the risks of complications, the following patient responsibilities must be maintained. These are:

    1. Excellent oral hygiene.

    2. Cooperation in keeping regularly scheduled clinic appointments.

    3. Mandatory compliance with instructions regarding the wearing of auxiliary, as well as removable appliances.

    4. Proper diet and nutritional controls, which include the avoidance of foods such as candy, gum, hard, sticky, or chewy foods, and sweets.

    5. Care of appliances and cooperation in making clinical appointments in the event of damage to or breakage of wires, springs, bands, and retainers.

    It has been explained and I understand that there is no specific warranty or guarantee as to any result and / or cure. I also understand that I can, at any time, ask for and receive a full recital of all possible complications and risks relevant to the orthodontic care of

     

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