Consent for Aligner Treatment

Name: Profile Orthodontics
Telephone: 08 9300 9975

Device Description

Aligners, consist of a series of clear plastic removable appliances that move your teeth in small increments. Aligners combine the Orthodontists 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. Upon approval of a treatment plan developed by our Orthodontists, a series of customized aligners are produced specifically for your treatment.

I understand the description of the aligner devices and how they work .

Procedure

The total number of aligners will vary depending on the complexity of the Orthodontists’ prescription. The aligners will be individually numbered and will be dispensed to you by your hygienist with specific instructions for use. Unless otherwise instructed by the Orthodontist or clinic team, you should wear your aligner’s full-time, remove them only when eating, drinking, brushing and flossing. As directed, you will progress to the next aligner in the series every one to three weeks. This will be determined by the clinical team at your appointments and the Dental Monitoring APP you use at home. Treatment times vary depending on the complexity of your case and your compliance with our instructions. Most patients will require bonded tooth coloured aesthetic attachments on their teeth to facilitate specific dental movements.

I understand the procedure for wearing and changing aligners as instructed.

Risks and Inconveniences

Like other orthodontic treatments, the use of aligners may involve some of the risks and inconveniences outlined below:

The success of aligner treatment depends on wearing the appliances for the required number of hours per day, using the products as directed, keeping your appointments, and the presence of typically-shaped teeth. Not meeting these conditions can lengthen the treatment time, adversely affect the treatment results and ultimately can cause treatment to fail.
Dental tenderness may be experienced after switching to the next aligner in the series.
The aligners may temporarily affect speech and may result in a lisp, although any speech impediment caused by the aligners should disappear within two or three days.
Aligners may cause a temporary increase in salivation or mouth dryness.
Attachments may be bonded to one or more teeth during the course of treatment
Teeth may require interproximal re-contouring in order to create space to allow tooth movement to occur. Atypically shaped teeth may lengthen the treatment time and affect results.
To track your compliance and tooth movement we will use a mobile device technology called “Dental Monitoring”. This is a compulsory part of your treatment plan, otherwise we may not be able to issue any further aligners to you.

I understand the procedure for wearing and changing aligners as instructed.

Respectful Behaviour

We're committed to providing a safe and respectful environment for everyone at our practice. We ask that all patients and their families treat our team with courtesy at all times. Aggressive, abusive, or disrespectful behaviour is not acceptable. If this occurs, we may need to end care and refer you to another provider.

I agree

Informed Consent

Please tick box to acknowledge that you have read each statement below

I have been given adequate time to read and have read the preceding information describing orthodontic treatment with aligners. I understand the benefits, inconveniences and risks associated with treatment. I have been sufficiently informed and have had the opportunity to ask questions and discuss concerns about my orthodontic treatment.

Due to the fact that orthodontics is working with biology, I acknowledge that the Orthodontist cannot make any guarantees or assurances concerning the outcome of my treatment.

I have read, understand and agree to the terms set out in this consent as indicated by signing below.

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