Informed Consent:  Wisdom Teeth and Extractions

I have reviewed the written and visual information provided to me.

The surgeon and/or staff have explained to me the proposed treatment. I understand there is always the option of no treatment.

I understand there are certain potential risks with the procedure. These include but are not limited to:

A dry socket (bone irritation) may occur a few days after surgery. This condition may cause increased pain and can be managed by the surgeon.

Infection could happen after the surgery which may require antibiotics, surgical drainage, and/or hospitalization.

Damage to the lower jaw nerves could occur after surgery and could result in temporary (6-12 months) or permanent (rarely) numbness or altered sensation (pain) to the lower lip, teeth, tongue and the chin areas.

If the upper teeth are close to your sinuses, their removal could cause a hole between the mouth and sinus. This may require additional surgery.

Stretching of the lips may cause irritation of the corners of the mouth.

Mild bleeding after the surgery is normal. There are occasional instances when increased bleeding may occur. Additional care by the surgeon may be necessary.

If the root tip of the extracted tooth breaks too close to a nerve or other vital structures, the surgeon may elect not to remove it.

I understand that the surgeon may require additional bone to be placed. Additional bone may be either harvested directly from the patient (autograft) and/or substituted with a commercially available human bone graft product (allograft). I understand that either type of bone graft may increase the risk of infection, may require further diagnostic tests, and may require further treatment.

Restricted mouth opening may occur for several days or weeks, with possible pain/clicking of jaw joint. Adjacent fillings, crowns and weakened teeth can be damaged during the extraction process. Responsibility for repair of same will rest with you, the patient.

If your surgery is done with sedation or under a general anesthetic, the following risks may occur inflammation of the I.V. site, nose bleeds, sore throat, hoarseness, lung problems, and/or heart problems.

Hospitalization after the surgery may be necessary to control medical and/or surgical complications.

In the unlikely event of a medical crisis requiring lifesaving action, our team will undertake a full resuscitative effort through to and including the arrival of Calgary Emergency Medical Services. Please tell us before treatment should you not wish this effort to be undertaken on your behalf.