Informed ConsentforComplete/Partial Dentures

1. Failure of Full Dentures: Some patients will not be able to tolerate wearing a prosthetic device. There are many variables that may contribute to this possibility such as:

   • Gum tissues that cannot bear the pressures placed upon them resulting in excessive tenderness and sore spots.
   • Jaw ridges that may not provide adequate support or retention.
   • Musculature in the tongue, floor of the mouth, cheeks, etc., which may not adapt to and be able to accommodate the artificial appliances.
   • Excessive gagging reflexes.
   • Either excessive saliva or dryness of the mouth.
   • General psychological or physical problems interfering with success.

2. Failure of Partial Dentures: In addition to the variables mentioned above, partial dentures may involve the following:

   • Natural teeth to which partial dentures are anchored (called abutment teeth) may become tender, sore, or mobile.
   • Abutment teeth may decay or erode around the clasps or attachments.
   • Tissues supporting the abutment teeth may fail.

3. Breakage: Due to the types of materials that are necessary for the construction of these appliances, breakage may occur even though the materials used were not defective. Factors which may contribute to breakage are:

   • Chewing on foods or objects that are excessively hard.
   • Gum tissue shrinkage causes excessive pressures to be exerted unevenly on the dentures.
   • Dentures having been dropped or damaged while outside the mouth.

4. Speech Problems: Time will be needed to adapt to a foreign material in the mouth. The speech will be altered when wearing dentures.

5. Loose Dentures: Full dentures normally become ill-fitting when there are changes in the supporting gum tissues. Dentures themselves do not change unless subjected to extreme heat or dryness. When dentures become "loose," relining the dentures may be necessary. There is a fee for the relining process. Partial dentures may need adjustments to the clasps that wrap around abutment teeth. With time, clasps can become brittle and break off. If that results in inadequate retention, a new partial denture will be needed. The fee is for a new partial denture.

6. Allergies to Denture Materials: Infrequently, the oral tissues may exhibit allergic symptoms to the materials used in the construction of either partial dentures or full dentures over which we have no control.

7. Failure of Supporting Teeth and/or Soft Tissues: Natural teeth supporting partial dentures may fail due to decay, excessive trauma, gum tissue, or bony tissue problems. This may necessitate extraction. The supporting soft tissues may fail due to many problems including poor dental or general health.

8. Check-ups are Still Necessary: Evaluation of the dentures, supporting teeth, and gums is necessary. If a problem is left to continue, it will lead to further damage. Check-ups should occur on a yearly basis.

Informed Consent: I can read and write English and have been given the opportunity to ask any questions regarding the nature and purpose of the proposed treatment and have received answers to my satisfaction. I do voluntarily assume any and all possible risks, including the risk of substantial harm, which may be associated with any phase of this treatment in hopes of obtaining the desired result. The fees for these services have been explained to me, and I accept them as satisfactory. By signing this form, I am freely giving my consent to authorize the doctors and staff at CLINICto render any services they deem necessary or advisable to treat my dental conditions, including the administration and/or prescribing of any anesthetic agents and/or medications.

Medications: Any medications dispensed or prescribed are the patient's responsibility to understand before taking them. Medication inserts are available from our office upon request. Particular attention should be given to possible allergic reactions, drug interactions with current medications, and their specific side effects.

Guarantees: The practice of dentistry is not an exact science, and no procedure is 100% successful. The doctors and/or staff at CLINIC have made no guarantees of a successful outcome.

Notifications: If a patient develops a problem, it is the patient's responsibility to notify the doctors and/or staff of CLINIC. Through this notification, we will be able to act on the patient's behalf. Attempts to correct a problem may occur at our office or a referral to another healthcare practitioner may be warranted.

Tooth Number:

Alternatives to the above treatment