Because of the wide difference among people and dental conditions, a successful outcome cannot always be obtained. This is true even for routine procedures. Sometimes, unexpected results occur. You should be aware of this potential before agreeing to continue.
Here are some of the more common (but not all) complications for extractions:
-Damage to nearby teeth
-Pain, swelling, bruising, infection, prolonged bleeding
-Dry socket (pain in the hole where the tooth was extracted)
-Parts of the tooth break off and may not be removed
-Permanent or temporary numbness to the cheeks, lip, tongue, teeth, gums
-Openings into the sinus (when upper teeth are extracted)
-Jaw dislocation or fracture
-TMJ problems (the joints in front of your ears)
Knowing that these risk exist and they might happen to me, I consent to allow this dental office to remove the tooth/teeth indicated above.
I have been given the opportunity to ask questions about this procedure and am fully satisfied with the answers I have received.