Implant Placement Consent Form

At Red Hill Dental Practice we make every effort to ensure a comfortable and predictable result, however, despite all of our best efforts, biological complications can still arise (as described below).

We use Straumann and Geistlich components and materials (manufactured in Switzerland and are of the highest quality) from start to finish. Straumann Dental Implants and components are made from Grade-4 Surgical Titanium. Geistlich bio-materials contain bovine (cow) bone and porcine (pig) collagen. We only use materials and products which we would be happy to have used on ourselves or our family members. If you have an objection to using animal-based products, please advise us well before your procedure so that alternative techniques may be discussed

Following implant placement, excellent oral hygiene, professional cleaning at least every six months, regular professional maintenance as advised and regular examinations (by the dentist) at least once a year are essential to achieve long-term success and for any warranty to remain valid. 

Complications can include soreness (or rarely pain), failure of the implant to integrate (i.e. the implant doesn’t bond to your bone, becomes loose and may lead to further bone loss in the area), minor temporary bleeding, bruising, swelling, infection, sore jaw joint, temporary or permanent nerve issues (including numbness) or altered sensation (including the nerves supplying sensation to neighbouring teeth, the lip, the chin, skin and tongue), temporary or permanent sinus or nasal issues, sutures (stitches), accidental swallowing or inhalation of materials/instruments, instrument displacement and/or fracture, and damage to adjacent teeth and surrounding soft tissues. Complications and issues may also arise that are caused by smoking, diabetes or existing medication (especially any medications which can affect blood clotting, bone healing, osteoporosis or bone cancer).

Please always ask your Dentist, Hygienist or one of our highly trained team if you have any questions regarding implants or any other treatment options discussed.

I confirm that:

1. The nature of the treatment, its purpose/s, approximate costs, risk/s, side effects, possible complications (including, but not limited to those listed above), expected longevity, maintenance requirements and alternative/s to me (including, but not limited to, leaving a gap, a bridge or a denture) has been fully explained to me;
   
   
2. I have been given the opportunity to ask questions about the proposed treatment and all questions that I have asked have been answered to my satisfaction;
   
   
3. I understand that should any change in the treatment plan or cost be required, it will be explained to me and my specific consent obtained;
   
   
4. I have been given sufficient time to understand, consider and consent to this treatment, and I have made an informed decision before choosing to proceed with the placement of a dental implant (and any associated materials).

135 Shoreham Road | info@rhdp.com.au | rhdp.com.au | 5989 2144