Successful orthodontic treatment is a partnership between the orthodontic team and the patient. Our doctors and staff are highly trained and dedicated to achieving the best possible result for each patient. As a general rule, informed and cooperative patients achieve positive orthodontic results in a timely manner. While recognizing the benefits of a healthy beautiful smile, you should also be aware that orthodontic treatment has limitations and potential risks, as with all medical treatment. These are seldom serious enough to indicate that you should not have treatment however all patients should consider the option of no orthodontic treatment and accept their present oral condition or discuss alternatives with their general dentist.
Results of Treatment
Orthodontic treatment usually proceeds as planned and we will do everything possible to achieve the best results for every patient. However, we cannot anticipate all possible complications or consequences. The success of treatment depends on your cooperation in keeping appointments, maintaining good oral hygiene, avoiding loose or broken appliances and following the orthodontist and team members’ instructions carefully. Due to the wide variation in the size and shape of the teeth, missing teeth, etc., additional restorative dental treatment may be needed to maximize the esthetic result.
General Health Problems
General health problems such as bone, blood or endocrine disorders and some prescription drugs (including bisphosphonates) can negatively affect your orthodontic treatment. It is imperative that you inform your orthodontist of your general health status and you are responsible to update the office of changes in health or medications.
Length of Treatment
Length of treatment depends on a number of issues including the severity of the problem, the patient’s growth and the level of patient cooperation. Actual treatment time is usually close to the estimated treatment time but treatment may be lengthened if unanticipated growth occurs, if there are habits affecting the oral structures, if periodontal or other dental problems occur or if patient cooperation is not adequate. Changes in the original treatment plan may become necessary.
Allergies
Occasionally, some patients can be allergic to some of the component materials of their orthodontic appliances. This may require a change in treatment plan or discontinuation of treatment prior to completion. Any known patient allergies should be disclosed to the orthodontist prior to beginning treatment.
Discomfort
The mouth is very sensitive so you can expect some temporary discomfort due to the placement of orthodontic appliances. Most of this discomfort will occur within a few days of the initial placement of the appliances. This discomfort is normal and expected. Non-prescription pain medication can be used during this adjustment period as the patient gets used to the appliances. The discomfort is temporary and should resolve in a few days.
Tooth Extractions
Some orthodontic cases will require the removal of deciduous (baby) or permanent (adult) teeth. The decision to recommend tooth extractions is taken very seriously. When indicated, we will refer the patient to their family dentist or an oral surgeon for the extraction. Please be aware that tooth extractions are not performed in our office.
Orthognathic Surgery
Some patients have significant skeletal disharmonies which require orthognathic (jaw) surgery in conjunction with orthodontic treatment. We will refer that patient to an oral surgeon for a surgical consultation before starting orthodontics.
Oral Hygiene
Excellent oral hygiene is essential during orthodontic treatment. General dental exams and cleanings are not performed in our office and we strongly recommend that all patients continue to visit their family dentist regularly. Inadequate or improper oral hygiene could result in cavities, discolored teeth, periodontal (gum) disease and/or decalcification.
Periodontal Disease
Periodontal (gum and bone) disease can develop or worsen during orthodontic treatment due to many factors. Our doctors will monitor the patient’s periodontal status during orthodontic treatment. If the periodontal condition worsens significantly, we will refer the patient to their general dentist or a periodontist for evaluation and treatment.
Root Resorption
The roots of some teeth may become shorter during orthodontic treatment. It is not known exactly what causes root resorption, nor is it possible to predict which patients will experience it. If resorption is detected during orthodontic treatment, your orthodontist may recommend a pause or discontinuation of treatment.
Nerve Damage
A tooth that has been traumatized by an accident or deep decay may have damage to the nerve. Although unlikely, orthodontic movement may aggravate this condition. In some cases root canal treatment or extraction may be necessary.
Temporomandibular Joint (TMJ) Dysfunction
Problems may occur in the temporomandibular joints (TMJ) causing pain or headaches. Many factors can affect the health of the jaw joints, including past trauma, arthritis, hereditary TMJ problems, excessive tooth grinding or clenching, poorly balanced bite and some other medical conditions. Joint problems may occur with or without orthodontic treatment. Any jaw joint symptoms, including pain, jaw popping or difficulty opening or closing, should be promptly reported to the orthodontist. Treatment by other medical or dental specialists may be necessary.
Occlusal Adjustment
You can expect minimal imperfections in the way your teeth meet following the end of treatment. An occlusal equilibration procedure may be necessary, which is a method used to fine-tune the occlusion (bite).
Relapse
Completed orthodontic treatment does not guarantee perfectly straight teeth for the rest of your life. Teeth will continue to shift throughout your life and retainers will be required to keep your teeth in their new positions. Even with proper retainer wear changes in tooth and bite alignment can occur due to natural causes, including growth and maturation that continue throughout life. Minor irregularities, particularly in the lower front teeth, may have to be accepted and some changes may require additional orthodontic treatment.
Please address any questions or concerns regarding this informed consent with your orthodontist before signing this document or beginning orthodontic treatment.