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I understand that there may be alternatives to the extraction
of teeth. After considering the various options, I have chosen
an extraction. I understand that there are various normal
complications that can occur despite all efforts to the
contrary as a result of the extraction(s) which include but
are not limited to:
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Allergic reaction to medications or anesthetics used
in the extraction process.
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Pain, swelling, infection, bruising, and bleeding.
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Stiffness of the adjoining or nearby muscles.
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Numbness – There is a possibility of injury to the
nerves of the face or tissues of the oral cavity
during the administration of anesthetics or during the
extraction, which may cause a numbness of the lips,
tongue, tissues of the mouth and/or facial tissue.
This numbness is usually temporary but may be
permanent.
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Fracture of the root of the tooth, which may also
result in the root tips being left in place or
displacement of the root tip into the sinuses and/or
nearby.
-
Dry sockets, aspiration and/or swallowing of foreign
objects.
-
Damage to adjacent teeth and/or restorations.
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I further understand that this procedure can also be performed
by a specialist and request that this treatment be performed
at this office by a general dentist.
No guarantee or assurance has been given to me by anyone that
the proposed treatment will cure or improve the conditions
listed above. I have read and understand the above and have
had all my questions answered to my satisfaction and I give my
consent to proceed with the recommended Extraction.
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