Implants Patient Consent Form

What Are Implants?

Implants differ from other replacements in that they are anchored in and supported by the jawbone. While there are important differences, they function more like your natural teeth. They may be used as a single tooth replacement or for multiple tooth replacement as anchors for fixed bridges, for removable partial and full dentures.

The implants are placed surgically. Usually under local anesthetic, the gum tissue is reflected, precise drilling of holes in the jawbone is performed to accommodate the implants (cylindrical metal posts) which are immediately placed in them. The surgical site is then closed. The second surgical procedure occurs three to eight months later. The implants are then evaluated for healing and successful integration with the bone. Some revisions may have to be made at this time. If the implant failed to integrate, it will have to be removed and alternative treatments considered, such as a change of the site or implant. If the implant has successfully integrated, a post is placed into the implant, extending through the gum tissue into the mouth. In the final prosthetic phase, a metal sleeve is threaded into the implant to anchor the crown, bridge or denture. The prosthetic (replacement crown, bridge or denture) fee is separate from the surgical fee.

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Alternatives To Implants

As implied above, alternatives to implant replacement may be fixed bridgework, removable partial and complete dentures. Infected teeth with sound roots and bone support may be treated by endodontic (root canal) therapy and restored with a post and crown. If presently wearing an ill-fitting denture, it should be replaced with a new one or relined for a better fit to keep the supporting tissue healthy. Non-replacement of missing teeth will usually cause movement of teeth, resulting in a collapsed bite, the correction of which may be difficult and costly.

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Surgical risks include, but are not limited to: post surgical infection; bleeding; swelling; pain; facial discoloration; sinus or nasal perforation; TMJ injuries; spasms; bone fracture; poor healing; numbness (paresthesia) of the lip, chin and tongue, which is usually temporary, but, on occasion, may be permanent.

The prosthetic risks include, but are not limited to: unsuccessful integration of the implant to the bone; fracture of the implant components. If a separate surgical procedure is necessary to remove a failed implant or if a replacement is necessary due to changed prosthetic requirements, an additional fee may be charged.

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Unanticipated Conditions

During the course of treatment, unknown oral conditions may modify or change the original treatment plan. This possibility necessitates consent for the treating doctor, in consultation with the patient, if possible, to use the best judgment in consideration of the new found conditions.

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You have been provided a general overview of implants. Implants have about an 85% success rate with various factors influencing the outcome. The benefits, as well as the risks, have been discussed. The alternatives to implant replacement have also been discussed, as well as the consequence of non-replacement. No discussion or form can be all inclusive and you are encouraged to ask questions regarding any concerns or needed clarifications, to enable you to make an informed decision. Dentistry is not an exact science. Every individual is unique and guarantees of success cannot be made.

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Lawrence West Dental
1141 Lawrence Ave. W.
North York, Ontario
M6A 1E1

Telephone: 416-785-8586
Fax: 416-785-3899

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Office Hours:
Monday: 8 - 8
Tuesday: 8 - 8
Wednesday: 8 - 8
Thursday: 8 - 8

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