Tooth Gems

I confirm that:

• I do not have any active tooth decay, gum disease, oral infections, or dental restorations (crowns, veneers, braces) that may interfere with the tooth gem placement. 
• I am not allergic to any dental materials including adhesives, etching agents, or gems.

• I have disclosed any pre-existing dental conditions or concerns to the technician. 

Procedure Understanding & Risks

I understand that:

• Tooth gems are temporary and typically last from a few weeks up to several months depending on oral habits. 
  
  
• There is no drilling or damage to the tooth, but improper care can lead to early gem loss or enamel wear. 
  
  

• Risks may include tooth sensitivity, irritation of the surrounding gum area, enamel damage, or allergic reaction. 

• The technician is not a licensed dentist, and this is a cosmetic enhancement, not a dental procedure. 

• I should consult a licensed dentist before proceeding if I have any concerns. 
  
  
• If gem falls off within 7 days from application, I can get a new gem replacement at no cost. 

Aftercare Agreement 

 

• Avoiding brushing the gem directly for 12-24 hours 
• Avoiding acidic foods, alcohol-based mouthwashes, and sticky foods for 24 hours
• Not using teeth to open or bite hard objects 
• Not attempting to remove the gem myself 

Liability Waiver

I release the technician and A.Rose Beauty from any and all claims of liability related to tooth gem application, including but not limited to camange to teeth, allergic reactions, or dissatisfaction with the appearance or longevity of the gem. I assume full responsibility for the outcome and understand this is a non-refundable service.

 

Signature & Acknowledgement

By signing below, I certify that

• I am at least 18 years of age or have legal guardian consent
• I have read, understood, and agree to all the terms above 
• All information provided is accurate and complete.