Dental Implant Consent Form

Purpose of the Consent: To provide written information regarding the risks, benefits, and alternatives of the treatment this consent is written. It is important that the patient should fully understand the treatment priorly. Before signing the consent, the patient should ask any of the questions regarding the treatment, dental implant and procedures to their doctor or healthcare professional.

The Treatment Information: As a surgical fixture dental implant is placed into the jawbone and allowed to fuse with the bone for a few months. The dental implant can be seen as artificial replacement for missing tooth root to hold a replacement tooth or bridge.

Risks and Side Effects: The possible side effects are listed below. However, the patients should be aware that there may be unique effects to certain people that are not known right now.
• Infection
• Gum recession
• Loose implant
• Nerve or tissue damage
• Sinus issues (pain, tenderness, or swelling around the cheeks, eyes, or foreheadgreen or yellow nasal mucus, a blocked nose, a reduced sense of smell, sinus headaches, toothache, bad breath, a high temperature)
• Damage from excessive force