Fixed prosthodontics Treatment (crown, bridge, inlay, veneers) Consent Form

I understand that the purpose of fixed prosthodontics treatment (crowns, bridges, inlays, veneers) is to restore function, improve aesthetics, and protect damaged teeth.

The procedure involves:

• Preparing the affected tooth/teeth by removing a portion of the enamel.
• Taking impressions or a digital scan of the prepared tooth/teeth.
• Fabricating the prosthetic (crown, bridge, inlay, veneer) in a dental laboratory.
• Placing and adjusting the prosthetic to ensure proper fit and function.

I understand that there are potential risks and complications, including but not limited to:

• Tooth sensitivity to hot and cold.
• Temporary or permanent nerve damage, which may cause numbness.
• Infection at the treatment site.
• Failure or dislodgement of the prosthetic, requiring repair or replacement.
• Root canal therapy – Due to crown preparation or cementation, the dental pulp might become inflamed, and the tooth may require a root canal before or after receiving a crown to prevent infection or possible extraction.
• Breakage of artificial dental crowns due to multiple factors.
• Unpredictable longevity – Regular dental check-ups are required. Patients should avoid harmful habits and use protective devices such as night guards or mouthguards as needed.

I understand the benefits of the treatment, which include:

• Improved ability to chew and speak.
• Enhanced appearance of the teeth and smile.
• Long-lasting restoration compared to other treatments.

I have been informed of alternative treatments, including:

• Fillings
• Removable dentures
• No treatment

I understand the importance of maintaining good oral hygiene and attending regular dental check-ups to ensure the longevity of the prosthetic.

I agree to follow the dentist's instructions for care and maintenance of the prosthetic and to report any issues or discomfort experienced after the procedure.

I acknowledge that I have read and understood the information provided above. I have had the opportunity to ask questions and have received satisfactory answers. I consent to proceed with the fixed prosthodontics treatment as described.

At any stage of treatment, the provider may refer the patient to an endodontist for further evaluation or treatment.