Dental Implant Consent for Surgery

  1. After a detailed study of my mouth, the Doctor in charge of the case informed me that the best treatment for the health of my mouth is: Implant surgery.
  2. After the implant surgery, I understand that I must follow these guidelines: good oral hygiene, reducing the use of alcohol and tobacco, and taking the prescribed medication.
  3. I understand that during the next 24-48 hours after the surgery, I may experience post-surgical effects such as mild pain, swelling of the surgical area, nerve damage, and infection.
  4. I must return in about two weeks to remove the stitches used to close the surgical site.
  5. I accept the possible risks of local anaesthesia injection, which are difficult to predict. These risks may include hypersensitivity, local damage by puncture, and hematomas.
  6. Inadequate oral hygiene, smoking and excess alcohol can affect the success of osseous integration. I understand that is the reason why periodic inspection visits are required.
  7. I understand that a small number of implants might fracture due to overload caused by the high forces generated by patients’ grinding and clenching their teeth.
  8. I have also been informed of the total price of this treatment.
  9. During the surgery, unforeseen situations may arise that require different procedures than those set forth above. Therefore, I authorize the Doctor and their associates to perform such procedures when necessary in their professional judgement. I understand I will have to pay the difference.
  10. 3StepsSmiles granted a ten years warranty for the implants and three years for my crown/bridge. After this warranty period, I am then eligible for all costs. In the future, the final crown/bridge/denture placed on the implant will likely need periodical replacement, refurbishment or maintenance.
  11. Peri-implantitis is a condition which may or may not occur after implant placement. A localized infection might cause progressive loss of bone around an implant.
  12. Once implants are placed, parts of the metal can become visible from time to time, either at the “neck” of the new tooth or by shining through the gum to show a grey area.
  13. Natural changes in the gums or jaws can create space underneath the prosthesis. Initially, this will feel unusual. However, it makes them easier to maintain and therefore is no cause for concern.
  14. There is a 1% chance of loss of implant integration with the jawbone. This loss can happen for various reasons such as changes to my general health, current oral hygiene measures, bite forces and standard biological rejection.
  15. Some of the most complex cases may not allow immediate teeth fixation due to poor bone quality or volume. In these unusual situations, I may have to wear a temporary denture. This case is infrequent and will have been discussed at full clinical assessment if it is a concern.
  16. If I have any questions or do not understand any aspect of the proposed treatment, I will contact 3 Step Smiles Dental Practice. This document is also part of my consent to the treatment. A copy of this document must be signed by me before the surgery accepting that I have read, understood and agreed to the previous terms.
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