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Informed Consent for Dental Implants

Informed Consent for Dental Implants

Precautions must be taken for dental implants in certain circumstances. You MUST inform the dentist prior to treatment if you:
1) have any of the following medical conditions:
• coagulopathy;
• heart condition;
• history of rheumatic heart disease;
• artificial heart valves;
• blood clotting disorders (Haemophilia, Von Willebrand’s disease, etc.);
2) are taking any of the following:
• blood thinning medication (Warfarin, Aspirin, etc.);
• medication affecting the bone (for osteoporosis, bone cancer, Paget’s disease).

Potential Complications
Placement of dental implants is considered minor oral surgery and has some inherent risks. Potential complications that can occur during preparation or placement of a dental implant include:
• Damage to adjacent teeth – Preparation of the implant site uses drill bits that may contact the adjacent tooth. That can inadvertently cause damage the crown and/or root of the adjacent tooth. This may also include any restorative material (fillings, crowns, etc.) associated with that tooth.
• Nerve damage – Preparation or placement of dental implants in the lower jaw can be in very close proximity to nerves that give feeling to your teeth, lips, and tongue. These nerves can potentially be damaged during the procedure, and can cause numbness to the areas they supply. Depending on the severity of the damage, the numbness can be temporary or permanent.
• Sinus or nasal perforation – Preparation or placement of dental implants in close proximity to the sinus or nasal cavity can cause a perforation into these areas. The implant may require removal, and management of the perforation can range from monitoring as it heals, to carrying out procedures to close the perforation.
• Weakness of fracture of the jaw – If the lower jaw bone is very thin, there is a chance fracture of the jaw bone can occur, in which the jaw may need to be fixed to heal properly.
• Inability to place dental implant – In rare circumstances, it is possible that the dental implant cannot be placed. Reasons can include, but are not limited to, complicated and unforeseen anatomy, failure of previous procedures upon which the placement of the implant is dependant upon (grafting, sinus lifts, etc.), poor bony quality, poor patient co-operation.
• Accidental swallowing of foreign matter – Componentry and material used for preparation and placement of dental implants is small and there is a risk of accidental swallowing.
Potential complications that can occur shortly after preparation or placement of a dental implant include:
• Bleeding – especially if taking blood thinning drugs (such as Warfarin, Aspirin, Clopidogrel, or Dipyrdamole). A spare pack of gauze will be provided to aid in stopping the bleeding, but if bleeding does not stop, contact your dentist for further management.
• Delayed healing and wound infection – Any surgical procedure introduces bacteria into the operative site and can result in wound infection. This can delay both the healing and progression of the treatment plan.
• Swelling and bruising – The local area may become swollen and bruised, but this will typically resolve in 7 days with maximal swelling from the third to fourth day after the procedure.
• Jaw joint swelling and restricted ability to open the mouth – The pressure on the jaw created by procedure itself or by keeping the mouth open for an extended time can cause the jaw joint to become swollen and restrict the ability to open the mouth. This should resolve after a few days.
• Failure to integrate – The bone may fail to integrate successfully with the implant, for a variety of reasons. Reasons can include, but are not limited to, poor bone anatomy/quality, presence of infection, damage to surrounding tissues, overloading, external forces/impact.
• Peri-implantitis – Infection may develop around an integrated dental implant. This can result in inflammation of the soft tissue, loss of bone around the implant, and ultimately loss of the implant. Patients with diabetes, smokers, patients with thin gums and those with poor oral hygiene are at greater risk of developing the infection.
• Fracture of implant or components – Repeated loading over time or a sudden impact can cause the implant or components (such as the prosthesis, abutment or screws) to fracture. In some cases, these can be repaired; in some cases, the implant may need removal.
• Allergic reactions – Implant components are composed of several different constituents, including but not limited to, titanium, gold, platinum, palladium, silver, copper, tin, nickel and ceramic. Some of these constituents may cause allergic reactions in susceptible patients.
• Shrinkage of gum tissue and bone – The surgical procedure involved with the placement of the implant can cause the gum tissue and bone to shrink. This can make the prosthetic tooth/teeth on top of the implant look longer than the other teeth, or even create black triangular spaces to develop between the prosthetic tooth and adjacent teeth.
• Affect on speech – The prosthetic tooth/teeth on top of the implant can feel different to natural teeth and affect the way you speak. The mouth normally becomes accustomed to this and should resolve in a few weeks.
Necessary Follow-up Care and Self Care
• Appointments following the procedure are required to monitor the healing. It is important to follow the specific prescriptions and instructions given by the dentist.
• Implants, natural teeth and artificial teeth must be maintained daily in a clean, hygienic manner. Implants and appliances must also be cleaned and examined periodically, and may need to be adjusted.

Alterative Treatment Options
There are other tooth replacement alternatives to dental implants. This can include:
• Partial or full dentures;
• Bridges (conventional, cantilever or Maryland).

The total cost of dental implants is as outlined in the treatment plan. The full amount of each individual dental implant (NOT including the prosthesis) is due on the day of the service.

Dental Implant sites:

• I have read and understand the conditions and information in this Consent Form.
• I have discussed the information contained in the Consent Form concerning Dental Implants with my dentist, and am satisfied with the answers that I have received.
• To my knowledge, I have given an accurate report of my physical and medical history.
• I have had explained to me the cost of the treatment and I accept responsibility for that cost.
• I understand the dentist has a special interest in periodontics, but is not a periodontist.
• I authorise my dentist to provide me with treatment dental implant(s).