Eden Orthodontics / Consent for Clear Aligners Treatment
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Consent for Clear Aligners Treatment

Dr Smith has recommended Clear Aligners for your orthodontic treatment. While recognising the benefits of teeth that function well and have a pleasing appearance, you should be aware that orthodontic treatment, like any treatment of the human body, has inherent risks and limitations.

Procedure

Clear Aligners consist of a series of clear plastic removable appliances that move your teeth in small increments. Clear Aligners combine your Orthodontist’s diagnosis and prescription with sophisticated computer graphics technology to develop a treatment plan which specifies the desired movements of your teeth during the course of your treatment.

Your Orthodontist will take a scan of your teeth and send it, along with a prescription to the laboratory. The laboratory will follow your Orthodontist’s prescription to create a model of your prescribed treatment. Upon approval of the treatment plan by your Orthodontist, the laboratory will produce and mail a series of customised aligners to your Orthodontist.

The total number of aligners will vary depending on the complexity of your Orthodontist’s prescription. The aligners will be individually numbered and will be dispensed to you by your Orthodontist with specific instructions for use. Unless otherwise instructed by your Orthodontist, you should wear your aligners for approximately 20 to 22 hours per day, removing them only to eat, brush, floss and to drink anything but water. You will change to the next aligner in the series as directed by your Orthodontist. Treatment duration varies depending on the complexity of your Orthodontist’s prescription.

Most patients may require bonded aesthetic attachments and/or elastics on their teeth during treatment to facilitate specific dental movements. Patients may require additional refinement after the initial series of aligners.

Monitoring

All patients will need to see their Orthodontist throughout the course of treatment.

Dental Monitoring® allows patients to submit records via an application on your smartphone using a ScanBox® for the purpose of progress tracking. You will be guided through taking the videos on a regular schedule suggested by Dental Monitoring® and refined by your Orthodontist. When the videos are taken, they are uploaded to the Dental Monitoring® doctor platform for review. You are able to review your past photos, replay your treatment evolution and receive notifications from your Orthodontist.

Dental Monitoring® is intended for use under orthodontic supervision and in no way replaces the expertise of your Orthodontist. Therefore, you still need to follow the recommendations of your Orthodontist.

Dental Monitoring replaces regular check-ups for some patients. If you do not wish to use or are not a suitable candidate for Dental Monitoring®, your Orthodontist will discuss this with you at the time of your consultation.

The Patient's Responsibilities

Clear Aligner treatment will not be successful if you do not comply with the directions given by your Orthodontist. Typically, these responsibilities include:

  • 1. Meticulous oral hygiene: thorough brushing at least three times a day.
  • 2. Routine dental visits: you must continue to see your dentist for regular check-ups - at least every 6 months.
  • 3. Correct use of the aligners and patient co-operation: orthodontic appliances are designed to deliver forces in a very specific manner. If the aligners are not worn as requested, the treatment will not proceed as planned.
  • 4. Care of the aligners: lost, broken or bent aligners disrupt the treatment plan.
  • 5. Regularly scheduled appointments: treatment progress must be monitored carefully. Missed or rescheduled appointments inevitably prolong treatment.

Risks and Inconveniences

Like other orthodontic treatments, the use of Clear Aligners and Dental Monitoring® may involve some of the risks outlined below:

  • 1. Failure to wear the appliances for the required number of hours per day, not using the products as directed by your Orthodontist, missing appointments, and atypically shaped teeth can lengthen the treatment time and affect the ability to achieve the desired results; If an appliance is not working as designed, unwanted tooth movement may occur.
  • 2. Dental tenderness may be experienced after switching to the next aligner in the series;
  • 3. Gums, cheeks and lips may be scratched or irritated;
  • 4. Temporary increase in salivation or dryness of mouth may occur;
  • 5. Teeth may shift position after treatment. Faithful wearing of retainers at the end of treatment should reduce this tendency;
  • 6. Tooth decay, periodontal disease, inflammation of the gums or permanent markings (e.g. decalcification) may occur if patients consume foods or beverages containing sugar, do not brush and floss their teeth properly before wearing the aligners, or do not use proper oral hygiene and preventative maintenance;
  • 7. The aligners may temporarily affect speech and may result in a lisp, although any speech impediment caused by the aligners, should disappear within one or two weeks;
  • 8. The bite may change throughout the course of treatment and may result in temporary patient discomfort;
  • 9. Health of the bone and gums which support the teeth may be impaired or aggravated;
  • 10. Oral surgery may be necessary to correct crowding or severe jaw imbalances that are present prior to wearing the aligners. If oral surgery is required, risks associated with anaesthesia and proper healing must be taken into account prior to treatment;
  • 11. A tooth that has been previously traumatised, or significantly restored may be aggravated. In rare instances the useful life of the tooth may be reduced, the tooth may require additional dental treatment such as endodontic and/or additional restorative work and the tooth may be lost;
  • 12. Existing dental restorations (e.g. crowns) may become dislodged and require re-cementation or in some instances, replacement;
  • 13. Atypically-shaped, erupting, and/or missing teeth may affect aligner adaptation and may affect the ability to achieve the desired results;
  • 14. Aligners are not effective in the movement of dental implants;
  • 15. In some patients, the length of the roots of the teeth may be shortened during orthodontic treatment. Some patients may be prone to this happening, some are not. It is nearly impossible to predict susceptibility. Usually, this shortening does not have significant consequences, but on very rare occasions it may become a threat to the longevity of the teeth involved. Progress x-rays will be taken to evaluate the status of the roots;
  • 16. General medical conditions and use of medications can affect orthodontic treatment;
  • 17. Product breakage has a higher probability in cases with multiple missing teeth;
  • 18. Orthodontic appliances or parts thereof may be accidentally swallowed or aspirated;
  • 19. In rare instances, problems may also occur in the jaw joint, causing pain, headaches or ear problems;
  • 20. Allergic reactions may occur;
  • 21. Teeth that are not at least partially covered by the aligner may undergo supra-eruption;
  • 22. Short clinical crowns can pose appliance retention issues and inhibit tooth movement;
  • 23. Teeth may require interproximal recontouring or slenderising/polishing in order to create space to allow tooth movement to occur;
  • 24. Attachments may be bonded to one or more teeth during the course of treatment;
  • 25. All attachments should be removed upon completion of treatment;
  • 26. In certain circumstances, the upload of Dental Monitoring® records may not occur;
  • 27. On rare occasions, the reception of Dental Monitoring® messages set by your Orthodontist may not occur.

    • Treatment Plan

    The Orthodontist will outline a Clear Aligner package suitable for your orthodontic treatment. Should you not follow the specific instructions for use and patient responsibilities this may result in prolonged treatment time and additional fees payable.

    If the treatment goals are not met with the Clear Aligner package selected, you are able to upgrade to a higher package with additional fees payable at the discretion of your Orthodontist.

    Consent

    I have been given adequate time to read and have read the preceding information describing orthodontic treatment with the Clear Aligner System and Dental Monitoring®. I understand the benefits, risks and inconveniences associated with treatment. I have been sufficiently informed and have had the opportunity to ask questions and discuss the concerns about orthodontic treatment with Clear Aligners and Dental Monitoring® products with my Orthodontist from whom I intend to receive treatment. I understand that I should only use the Clear Aligners and Dental Monitoring® products after consultation and prescription from a certified Orthodontist, and I hereby consent to orthodontic treatment with Clear Aligners and Dental Monitoring® products that have been prescribed by my Orthodontist. Due to the fact that orthodontics is not an exact science, I acknowledge that my Orthodontist, the Clear Aligner provider and Dental Monitoring® have not and cannot make any guarantees or assurances concerning the outcome of my treatment. I understand that the Clear Aligner provider and Dental Monitoring® are not providers of medical, dental or health care services and do not and cannot practice medicine, dentistry or give medical advice. No assurances or guarantees of any kind have been made to me by my Orthodontist, the Clear Aligner provider or Dental Monitoring®, its representatives, successors, assigns and agents concerning any specific outcome of my treatment. I agree to read and follow all the instructions for use that come with my Clear Aligner treatment.

    I understand and give consent for treatment to be provided by registered Orthodontic Specialists, registered Orthodontic Auxiliaries and Orthodontic Auxiliaries in an accredited training program.

    I consent to Eden Orthodontics collecting and keeping information about my health for the purpose of making sure I receive appropriate care and treatment, and for the associated administrative tasks. I agree to provide this information voluntarily. I understand and agree to my health information being stored overseas and I have been notified of this arrangement. I am entitled to request access to correction of my health information.

    I authorise my Orthodontist to release my medical records, including, but not limited to, radiographs (xrays), scans, reports, charts, medical history, photographs, findings, plaster models or impressions of teeth, prescriptions, diagnosis, medical testing, test results, billing and other treatment records in my Orthodontist’s possession (“Medical Records” ) (i) to other licensed dentists or orthodontists and organisations employing licensed dentists and orthodontists and to the Clear Aligner provider, its representatives, successors, assigns and agents for the purposes of investigating and reviewing my medical history as it pertains to orthodontic treatment with products from the Clear Aligner provider and (ii) for educational and research purposes.

    I acknowledge that use of my medical records is without compensation and that I will not, nor shall anyone, on my behalf have any right of approval, claim of compensation, or seek or obtain legal, equitable or monetary damages or remedies arising out of any use such that comply with the terms of this consent. A photostatic copy of this consent shall be considered as effective and valid as an original. I have read, understand, and agree to the terms set forth in this consent as indicated by my signature below.

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