Removal of Tooth - Patient Consent Form

Even with proper care, every operation carries some risk, and complications may occur. Therefore, it is important that you are aware of the possible complications resulting from the procedure. As every case is unique, the risks are assessed and explained to you on an individual basis.

• Pain, discomfort, and tenderness of the extraction site and surrounding area are to be expected.
  
  
• Swelling – there will be swelling, which will at its greatest around 24 to 48 hours after the procedure
  
  
• Difficulty opening your mouth for that period
  
  
• Inability to eat solid foods for around 4 or 5 days
  
  
• Dry Socket if the blood clot is lost due to premature rinsing, smoking, hot drinks, weak immune system, etc
  
  
• Bleeding and oozing for around 24 hours
  
  
• Bruising of your face
  
  
• Expressing small sharp bone fragments afterwards

• Post operative infection – Routine prescription of Antibiotics as prevention. Very rarely, you may get a late (2-4 weeks after surgery) post-operative infection, i.e., swelling will occur even though the gum seems to have healed. Please contact us straight away; you will need a 2nd and longer prescription of antibiotics.
  
  
• Please note that antibiotics may interfere with any oral contraceptives you may be taking, so please ensure you use extra precautions (eg, barrier contraceptive) for one full cycle following the usage of antibiotics.
  
  
• Maxillary Sinus exposure – This can rarely occur if the upper wisdom tooth is positioned very high up in the jaw (near the sinus) or there is a cyst/pathology associated with the tooth.
  
  
• Osteonecrosis (non-healing of the bone) – very rare in healthy patients, only mildly likely in patients with a history of IV bisphosphonates (e.g., IV Fosamax for cancer treatment) or those currently on it.
  
  
• Swallowing or inhaling the tooth fragment or debris.
  
  
• Nerve damage - Lower impacted teeth usually rest on the main nerve to the lower jaw and are often near the main nerve to the tongue. Sometimes, in spite of all precautions, these nerves are bruised or stretched. The result may be an altered sensation which is often partial or complete numbness of the lower lip, chin, inside of the cheek, all the teeth on that side, or the side and tip of the tongue. In most cases, the effect does not last more than a few weeks, improving as the nerve repairs it. In some cases, the altered sensation may last several months or years and may be permanent. The occurrence and duration of this problem is unpredictable. Altered sensation does not affect the appearance
  
  
• Leaving root fragments behind – occasionally, if the roots are very deep, curled or 'wrapped' around your nerves, we may have to do what we term a 'Decoronation' which means to remove most of the tooth, but some of the root is left behind. The reason we do this is the removal of the last portion of the root carries a greater risk of damage to surrounding structures e.g., permanent nerve damage. If any fragment of the root is left behind, most of the time, it will heal very well around the area alternative, in a small proportion of cases, the root will 'float' up to the top of the gum, where is more easily removed at a later stage (between a few months – years).
  
  

Please remember that any surgery carries some small degree of risk; however, we will do our utmost to deliver the highest quality care to minimize any post-operative problems.

My doctor has explained the procedure I am about to receive prior to the operation. I have had the opportunity to have any questions answered to my full satisfaction. I shall diligently follow all post-operative instructions given to me.