Invisalign Consent

  • Informed Consent for the Invisalign Patient

    Generally, EXCELLENT INVISALIGN RESULTS can only be achieved with informed and cooperative patients. Invisalign treatment remains an elective procedure. It, like any other treatment of the body, has some inherent risks and limitations. These risks are seldom serious enough to contra-indicate Invisalign treatment, but should be considered when you decide to begin Invisalign treatment. You are therefore urged to read the following information, ask any questions which come to mind, then consent to our treating you or your child by initialing after each statement and signing at the bottom of the form. I feel that the benefits from Invisalign treatment do outweigh the risks; however, I need you to make your own decision.

    • PATIENT COOPERATION

      The total time required to complete treatment may exceed our estimate. Excessive bone growth, poor oral hygiene or poor cooperation in wearing the appliance 21 to 22 hours per day, broken appliances and missed appointments can lengthen the treatment time, increase treatment costs, and affect the quality of the end result.

    • COMPLETION OF TREATMENT WITH or WITHOUT BRACES

      Our office is proud of our results with hundreds of patients that have completed treatment with 100% Invisalign. We have offered approximately 3% of our patients the option of clear standard braces to achieve more ideal results than we were able to get with Invisalign alone. If this option is offered, it is without additional fee and the final decision is made by the patient, not the doctor.

    • DENTAL DISEASE, DECALCIFICATION

      Tooth decay, gum disease and permanent markings on teeth are fully preventable, but can occur if Invisalign patients eat food containing excessive sugar and/or do not clean their teeth frequently and properly.

    • NON-VITAL TOOTH

      An injured tooth can die over a period of time with or without Invisalign treatment and it may not be obvious that a tooth was previously injured. This tooth may flare up during Invisalign movement and require root canal treatment. This occurrence is seldom due to Invisalign and is more frequently related to a previous accident. Your general dentist would need to perform a root canal treatment if the tooth should flare up before, during, or after Invisalign treatment.

    • ROOT RESORPTION – SHORTENING OF THE ROOTS

      This can occur with or without Invisalign treatment. Under healthy conditions, the shortened roots usually are not a problem. In very rare cases, shortened roots can be a cause of loose teeth.

    • PERIODONTAL PROBLEMS

      Swollen, inflamed and bleeding gums can usually be prevented by proper and regular flossing and brushing. Periodontal disease can become serious and cause the loss of teeth. Should the condition become uncontrollable, Invisalign treatment may have to be discontinued short of completion. This would be rare, usually in adults with a pre-existing periodontal problem.

    • RELAPSE

      Teeth have a tendency to partially rebound toward their original positions after treatment. Rotations and crowding of lower anterior teeth are most common examples. Teeth also tend to drift forward in the mouth over the years. We advise wearing retainers every night for the first year, and most every night from then on to avoid these biological changes. Usually a high percentage of the correction and good cosmetics can be maintained when retainers are worn in this manner.

    • SLENDERIZING AND RESHAPING TEETH

      In attempting to straighten the teeth, but keep the removal of any teeth to a minimum, we often sand away small amounts of tooth enamel between teeth, We also may reshape the sides or edges to improve shape.

    • ALLERGIC REACTIONS

      Allergies to medicines and Invisalign materials may occur during treatment. If you are aware of these allergies they can be avoided, but of they are unknown to you, it is impossible to predict any reaction. People who are already allergic to certain foods are more prone to allergies to materials. Some allergies that we are aware of include latex (gloves and rubber bands) and metals (such as Nickel).

    • TEMPORO-MANDIBULAR JOINT DISFUNCTION (TMJ)

      Patients with malocclusions may have a high potential for TMJ (or temporo-mandibular) problems, which may become evident before, during or after Invisalign treatment. These may include joint pain, ear pain, and/or headaches. Invisalign treatment may help remove the dental causes of the TMJ Syndrome but not the non-dental causes. TMJ problems can be both painful and expensive to treat. We may need to refer you to a doctor who specializes in TMJ problems, and this would be a separate fee at that doctor’s office.

    • IF THE PATIENT IS STILL GROWING

      Occasionally, unexpected or abnormal changes in the growth of the jaws or shape and size of the teeth may limit our ability to achieve the desired result. If growth becomes disproportionate, the bite may change, requiring additional treatment or, in some cases, oral surgery. Growth disharmony is a biological process beyond the orthodontist’s control.

    • UNUSUAL OCCURRENCES

      Sometimes Invisalign appliances may be accidentally swallowed or aspirated, or may irritate or damage the oral tissue. Teeth may be chipped or restorations (fillings or crowns) dislodged.

    • TREATMENT OPTIONS -- COSMETIC RESULTS ONLY, TOOTH EXTRACTIONS, or ORAL SURGERY

      Sometimes to obtain more than just cosmetic improvements, simple or even complex oral surgery could be necessary in conjunction with Invisalign treatment, especially to correct severe jaw imbalances. We suggest that if you are considering this option, that you discuss risks with your oral surgeon before making your decision to proceed with the surgery. If you decline the option of “ideal treatment” we will explain as best we can the cosmetic improvements to the smile that are possible without surgery.

    • CLEAR BUTTONS and TOOTH COLORED ATTACHMENTS

      If attachments or buttons are needed on the front teeth, they do show more than if we do not need them. These auxiliaries are commonly needed and we request your permission to use these when needed. There is a very slight risk that some of the tooth’s enamel may be removed inadvertently.

    • DENTAL CHECK-UPS

      Each Invisalign patient MUST be under the care of a general dentist, and your general dentist may refer adult patients to a periodontist (gum specialist). It is essential that Invisalign patients have regular dental check-ups and cleanings as directed by your general dentist (usually in intervals of 3 to 6 months between cleanings).

    • SPACES BETWEEN TEETH

      Completion of Invisalign treatment, especially in adults, can result in slight spaces between some teeth. This is especially true if teeth were extracted, or if the widths of individual teeth are inconsistent. Also, in some adults with very crowded teeth, the gum tissues do not fill in, so there appears to be a space between teeth due to missing gum tissue.

  • I have read, understood, and have had all my questions regarding the risks and limitations of Invisalign treatment answered, as I have indicated by my initials above. I further understand that one of the alternatives is no treatment. I also understand that should any of the above conditions threaten the health of this patient, treatment may be terminated.

  • Patient, or Responsible Party for a Minor
  • Signature (patient/legal guardian/authorized representative
  • Date
  • This field is for validation purposes and should be left unchanged.