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Benefits & Risks Consent

Northwest Orthodontics – General information for patients on the benefits and risks of orthodontic treatment, commonly used orthodontic appliances and the commitment required from patients during and after their orthodontic treatment.

We are dedicated to achieving the best possible results for all our patients but, as with all medical and dental treatments, orthodontic treatment has limitations and potential risks.

The risks are seldom serious enough to prevent you from starting orthodontic treatment but, as part of your decision making process, you should discuss all alternatives treatment options with your orthodontist including not having any orthodontic treatment.

BENEFITS OF ORTHODONTIC TREATMENT

Orthodontic treatment helps create balance and harmony between the teeth and face and this can help improve chewing efficiency and smile cosmetics.

Properly aligned teeth are easier to keep clean, and this may decrease the tendency for tooth decay or gum disease.

RISKS OF ORTHODONTIC TREATMENT

DECALCIFICATION: permanent markings (decalcification) can occur on the teeth if patients do not brush their teeth as advised or if they frequently consume sugary and/or acidic foods.

These same problems can occur without orthodontic treatment, but the risk is greater to an individual wearing braces.

GUM DISEASE: Health of the bone and gums which support the teeth may be compromised if plaque is not removed from these areas with good oral hygiene. These same problems can occur without orthodontic treatment, but the risk is greater to an individual wearing braces.

ROOT SHORTENING: In some patients the length of the roots may be shortened during orthodontic treatment. Usually this is minimal and does not have any significant consequences, but in some cases it may become a threat to the longevity of the teeth involved. Previous trauma to teeth, nail biting or even pen chewing may exacerbate root shortening.

JAW JOINT PROBLEMS: Occasionally patients may have problems from with their jaw joints causing joint pain, headaches or ear problems. These problems can occur with or without orthodontic treatment and may worsen, improve, or stay the same during orthodontic treatment.

LOSS OF TOOTH VITALITY: Sometimes a tooth can have nerve damage which may or may not be evident to the patient or their dentist e.g previous trauma or having a filling placed in it. Orthodontic tooth movement may aggravate this nerve damage and in rare instances may lead to loss of vitality and the need for root canal treatment.

UNFAVOURABLE GROWTH: In some cases jaw growth can become disproportionate during treatment and the bite may change. This may require additional treatments or, in some cases, treatment to be stopped and later jaw surgery. In rare cases growth changes can also occur after the orthodontic treatment and may alter the quality of treatment results.

UNCOMMON OCCURANCES:  Swallowed appliances, chipped teeth, dislodged restorations and allergies to latex or nickel rarely occur but are possible. Root treated teeth may also give problems if they are moved with orthodontic treatment

ADJUNCTIVE DENTAL CARE:  Due to the wide variation in the size and shape of teeth, achievement of the most ideal result may require restorative dental treatment, by their dentist, in addition to orthodontic care. The most common types of treatment are cosmetic bonding (white fillings as “build ups”), crown and bridge restorations and periodontal therapy.

LIMITATIONS OF TREATMENT: While we aim to provide the best possible result for all our patients unknown factors such as poor response to treatment or unexpected jaw growth mean that we cannot definitively guarantee that every patient will achieve 100% of their pre-treatment expectations. These factors can also mean that the treatment plan may need adjusted as the treatment progresses. The new plan will be discussed with you if this occurs.

In some cases existing pre-treatment factors such as missing teeth or lack of growth can mean that an improved but non-comprehensive result may be all that is possible for some patients.

RELAPSE TENDENCY: For various reasons the teeth may have a tendency to want to change their positions after orthodontic treatment. Wearing and replacing the orthodontic retainers as instructed should prevent this tendency but in some cases minor movement can occur even with correct retainer wear.

EXTENDED TREATMENT TIME: The total time required to complete treatment may exceed the original estimate. Excessive or deficient bone growth, poor cooperation in wearing the appliance(s), poor oral hygiene, broken appliances and missed appointments can all lengthen the treatment time and affect the quality of the end results.

EARLY TERMINATION OF TREATMENT: the practice reserves the right to terminate a patient’s treatment in cases where the supervising clinician feels it is non-longer in the best interest of the patient to continue with treatment.

This includes, but is not limited to, poor patient cooperation (e.g. multiple missed appointments, failure to wear appliances properly, multiple appliances breakages), patients relocating or a breakdown in the patient/clinician relationship. If termination of treatment is necessary the braces will be removed and retainers provided if necessary.

TYPES OF ORTODONTIC APPLIANCES WE COMMONLY USE

REMOVABLE ORTHODOTNIC APPLIANCES:  These are typically made from plastic and wire components. We use them for simple interceptive corrections or for specific tooth movements where they can more effective than a fixed appliance. They are usually fitted on the top teeth but can also be used on the lower teeth if needed. They commonly precede fixed appliance treatment.

FUNCTIONAL ORTHODONTIC BRACES: A specially designed combination of an upper and lower removable brace appliances used to functionally stimulate block tooth movement and maximise any favourable jaw growth potential. These are commonly used in cases where the top teeth sit significantly in front of the lower teeth due to a shorter lower jaw. They are only used in growing children.

FIXED ORTHODOTNIC APPLIANCES:  Commonly called ‘train tracks’ these braces consist of metal or ceramic brackets which are fixed to the outside of the teeth with special adhesives. A wire is tied into the bracket and the combination of the bracket and wire is used to align the teeth.

Fixed orthodontic braces allow maximum control of the teeth and are used in most of the cases we treat. Ceramic brackets are not available to NHS patients.

TRANS-PALATAL ARCH: this is a thin bar that runs across the roof of the mouth and is held in by bands cemented to the back teeth. It forms part of a fixed appliance and is used to control the teeth at the back of the mouth.

INVISALIGN ALIGNERS: These are clear thin gum-shield type appliances with fit over the teeth and are changed every week. Sometimes tooth coloured bumps are glued onto the teeth to help the aligner have better control over the teeth – these bumps are removed at the end of treatment. Invisalign is not available to NHS patients.

RETAINERS: Retainers are used once the orthodontic treatment has been completed to ensure the teeth are kept in their post treatment position. The practice uses both removable and permanent retainers depending on the requirements of the individual case. Patients are encouraged to continue wearing their retainers as directed on a long term basis.

THE PATIENTS RESPONSIBILITIES IN THEIR ORTHODONTIC TREATMENT

It is the patients responsibility to fully co-operate with all aspects of the orthodontic treatment to help ensure that the treatment will progress appropriately and that the best possible results can be achieved without any iatrogenic damage occurring.

In this regard patients are expected to:

  • Maintain a high level of oral hygiene throughout their treatment.
  • To attend all appointments on the proper day and time.
  • Adhere to any advice given on food restrictions with a view to preventing damaging their teeth or the orthodontic appliances.
  • Adhere to any specified treatment requirements such as proper appliance wear, proper appliance care and elastic wear etc.
  • To continue to visit their general dentist at least every 6-12 months for an examination and cleaning.
  • Contact the practice for advice immediately should any problems arise during their treatment.

Failure of the patient to cooperate with the treatment may result in damage to the teeth, damage to the supporting structures of the teeth or the treatment taking much longer than originally expected. It certain cases it may also result in the treatment being terminated early and a less than ideal result being achieved.

Patients should be aware that there may be additional charges for the replacement of appliances (such as retainers or removable braces) that are lost or damaged due to repeated patient neglect – this is the case even if the patient is eligible for NHS fully exempt care.

It is the responsibility of the patient (and parent/guardian) to thoroughly study this material and any other informational/ instructional literature given to them and follow given instructions completely.