Terms and Conditions

Please note that a larger print version of these terms and conditions is available from the Dentist on request.

1. Definitions

1.1 “Dentist” means Amdent Pty Ltd T/A DentalCare Carnegie its successors and assigns or any person acting on behalf of and with the authority Amdent Pty Ltd T/A DentalCare Carnegie.

1.2 “Patient” means the person/s requesting the Dentist to provide the Services as specified in any invoice, document or order, and if there more than one person requesting the Services is a reference to each person jointly and severally.

1.3 “Incidental Items” means any goods or materials supplied, consumed, created or deposited incidentally by the Dentist in the course of it conducting, or supplying to the Patient, any Services.

1.4 “Services” means all Services supplied by the Dentist to the Patient at the Patient’s request from time to time.

1.5 “Price” means the price payable for the Services as agreed between the Dentist and the Patient in accordance with clause 3 of this contract.

2. Acceptance

2.1 The Patient is taken to have exclusively accepted and is immediately bound, jointly and severally, by these terms and conditions if the Patient places an order for, or accepts Services provided by the Dentist. The patient understands and consents to the use of audio and video recording within the practice premises, and the recording may be used as evidence of consent and shared with third parties for the purposes of enforcing these terms and conditions.

2.2 These terms and conditions may only be amended with the Dentist’s consent in writing and shall prevail to the extent of any inconsistency with any other document or agreement between the Patient and the Dentist.

2.3 The Patient undertakes to give the Dentist at least fourteen (14) days notice of any change in the Patient’s name, address and/or any other change in the Patient’s details.

3. Price and Payment

3.1 At the Dentist’s sole discretion the Price shall be either: (a) as indicated on any invoice provided by the Dentist to the Patient; or (b) the Dentist’s quoted price (subject to clause 3.2) which will be valid for the period stated in the quotation or otherwise for a period of thirty (30) days.

3.2 The Dentist reserves the right to change the Price if a variation to the Dentist’s quotation is requested or where the variation is due to increase to the Dentist in the costs of materials and/ or labour which are beyond the Dentist’s reasonable control.

3.3 At the Dentist’s sole discretion a non-refundable deposit may be required.

3.4 Time for payment for the Services being of the essence, the Price will be payable by the Patient on the date/s determined by the Dentist, which may be: (a) on the day of treatment; or  (b) before treatment; or  (c) by way of instalments in accordance with the Dentist’s payment schedule; (d) the date specified on any invoice or other form as being the date for payment; or (e) failing any notice to the contrary, the date which is seven (7) days following the date of any invoice given to the Patient by the Dentist.

3.5 Payment may be made by cash, cheque, bank cheque, electronic/on-line banking, credit card (plus a surcharge of up two and a half percent (2.5%) of the Price), or by any other method as agreed to between the Patient and the Dentist.

3.6 Unless otherwise stated the Price does not include GST. In addition to the Price the Patient must pay to the Dentist an amount equal to any GST the Dentist must pay for any supply by the Dentist under this or any other agreement for providing the Dentist’s Services. The Patient must pay GST, without deduction or set off of any other amounts, at the same time and on the same basis as the Patient pays the Price. In addition the Patient must pay any other taxes and duties that may be applicable in addition to the Price except where they are expressly included in the Price.  

4. Delivery of Services  

4.1 The dentist will require certain diagnostic tests at the initial consultation to be performed prior to forming a diagnosis and treatment plan and delivering services to the patient. Such tests may include but are not limited to: X-ray radiographs, clinical photographs, thermal and electrical pulp tests, periodontal probing. The cost of these tests shall not exceed $250, and the patient consents to these tests in order to arrive at a diagnosis, with consent evident by the signature on the New Patient form. The tests carry very small risks associated with diagnostic doses or radiation exposure. It is the patient’s responsibility to inform the dentist of any pregnancy at the beginning of each appointment, so that appropriate measures may be taken to shield the patient from radiation. The Dentist may deliver the Services by separate instalments. Each separate instalment shall be invoiced and paid for in accordance with the provisions in these terms and conditions.

4.2 Any time specified by the Dentist for delivery of the Services is an estimate only and the Dentist will not be liable for any loss or damage incurred by the Patient as a result of failure by the Dentist to deliver the Services promptly or at all. However both parties agree that they shall make every endeavour to enable the Services to be supplied at the time and place as was arranged between both parties.

5. Risk

5.1 Irrespective of whether the Dentist retains ownership of any Incidental Items all risk for such items shall pass to the Patient as soon as such items are delivered to the Patient and shall remain with the Patient until such time as the Dentist may repossess the Incidental Items.

6. Title

6.1 The Dentist and the Patient agree that where it is intended that the ownership of Incidental Items is to pass to the Patient that such ownership shall not pass until: (a) the Patient has paid the Dentist all amounts owing for the Services; and (b) the Patient has met all other obligations due by the Patient to the Dentist in respect of all contracts between the Dentist and the Patient.

6.2 Receipt by the Dentist of any form of payment other than cash shall not be deemed to be payment until that form of payment has been honoured, cleared or recognised and until then the Dentist’s ownership or rights in respect of the Incidental Items shall continue.

6.3 It is further agreed that: (a) the Patient is only a bailee of the Incidental Items and must return the Incidental Items to the Dentist immediately upon request by the Dentist;  (b) the Patient holds the benefit of the Patient’s insurance of the Incidental Items on trust for the Dentist and must pay to the Dentist the proceeds of any insurance in the event of the Incidental Items being lost, damaged or destroyed; (c) the Patient must not sell, dispose, or otherwise part with possession of the Incidental Items. If the Patient sells, disposes or parts with possession of the Incidental Items then the Patient must hold the proceeds of sale of the Incidental Items on trust for the Dentist and must pay or deliver the proceeds to the Dentist on demand. (d) the Patient should not convert or process the Incidental Items or intermix them with other goods, but if the Patient does so then the Patient holds the resulting product on trust for the benefit of the Dentist and must dispose of or return the resulting product to the Dentist as the Dentist so directs.   (e) the Patient shall not charge or grant an encumbrance over the Incidental Items nor grant nor otherwise give away any interest in the Incidental Items while they remain the property of the Dentist; (f) the Patient irrevocably authorises the Dentist to enter any premises where the Dentist believes the Incidental Items are kept and recover possession of the Incidental Items. 

7. Personal Property Securities Act 2009 (“PPSA”)

7.1 In this clause financing statement, financing change statement, security agreement, and security interest has the meaning given to it by the PPSA.

7.2 Upon assenting to these terms and conditions in writing the Patient acknowledges and agrees that these terms and conditions constitute a security agreement for the purposes of the PPSA and creates a security interest in all Incidental Items that have previously been supplied and that will be supplied in the future by the Dentist to the Patient.

7.3 The Patient undertakes to: (a) promptly sign any further documents and/or provide any further information (such information to be complete, accurate and up-to-date in all respects) which the Dentist may reasonably require to;

(i) register a financing statement or financing change statement in relation to a security interest on the Personal Property Securities Register; 

(ii) register any other document required to be registered by the PPSA; or

(iii) correct a defect in a statement referred to in clause 

7.3(a)(i) or 7.3(a)(ii); (b) indemnify, and upon demand reimburse, the Dentist for all expenses incurred in registering a financing statement or financing change statement on the Personal Property Securities Register established by the PPSA or releasing any Incidental Items charged thereby; (c) not register a financing change statement in respect of a security interest without the prior written consent of the Dentist; (d) not register, or permit to be registered, a financing statement or a financing change statement in relation to the Incidental Items in favour of a third party without the prior written consent of the Dentist.

7.4 The Dentist and the Patient agree that sections 96, 115 and 125 of the PPSA do not apply to the security agreement created by these terms and conditions. 

7.5 The Patient waives their rights to receive notices under sections 95, 118, 121(4), 130, 132(3)(d) and 132(4) of the PPSA. 

7.6 The Patient waives their rights as a grantor and/or a debtor under sections 142 and 143 of the PPSA. 

7.7 Unless otherwise agreed to in writing by the Dentist, the Patient waives their right to receive a verification statement in accordance with section 157 of the PPSA. 

7.8 The Patient must unconditionally ratify any actions taken by the Dentist under clauses 7.3 to 7.5. 

7.9 Subject to any express provisions to the contrary nothing in these terms and conditions is intended to have the effect of contracting out of any of the provisions of the PPSA. 

8. Security and Charge

8.1 In consideration of the Dentist agreeing to supply Services, the Patient charges all of its rights, title and interest (whether joint or several) in any land, realty or other assets capable of being charged, owned by the Patient either now or in the future, to secure the performance by the Patient of its obligations under these terms and conditions (including, but not limited to, the payment of any money). 

8.2 The Patient indemnifies the Dentist from and against all the Dentist’s costs and disbursements including legal costs on a solicitor and own client basis incurred in exercising the Dentist’s rights under this clause.

8.3 The Patient irrevocably appoints the Dentist and each director of the Dentist as the Patient’s true and lawful attorney/s to perform all necessary acts to give effect to the provisions of this clause 8 including, but not limited to, signing any document on the Patient’s behalf. 

9. Defects, Warranties and the Competition and Consumer Act 2010 (CCA)

9.1 The Patient must inspect the Dentist’s Services on completion of the Services and must within seven (7) days notify the Dentist in writing of any evident defect in the Services or Incidental Items provided (including the Dentist’s workmanship) or of any other failure by the Dentist to comply with the description of, or quote for, the Services which the Dentist was to supply. The Patient must notify any other alleged defect in the Dentist’s Services or Incidental Items as soon as is reasonably possible after any such defect becomes evident. Upon such notification the Patient must allow the Dentist to review the Services or Incidental Items that were provided.

9.2 Under applicable State, Territory and Commonwealth Law (including, without limitation the CCA), certain statutory implied guarantees and warranties (including, without limitation the statutory guarantees under the CCA) may be implied into these terms and conditions (Non-Excluded Guarantees). 

9.3 The Dentist acknowledges that nothing in these terms and conditions purports to modify or exclude the NonExcluded Guarantees. 

9.4 Except as expressly set out in these terms and conditions or in respect of the Non-Excluded Guarantees, the Dentist makes no warranties or other representations under these terms and conditions including, but not limited to, the quality or suitability of the Services. The Dentist’s liability in respect of these warranties is limited to the fullest extent permitted by law. 

9.5 If the Patient is a consumer within the meaning of the CCA, the Dentist’s liability is limited to the extent permitted by section 64A of Schedule 2.

9.6 If the Dentist is required to rectify, re-supply, or pay the cost of re-supplying the Services under this clause or the CCA, but is unable to do so, then the Dentist may refund any money the Patient has paid for the Services but only to the extent that such refund shall take into account the value of Services and Incidental Items which have been provided to the Patient which were not defective.

9.7 Subject to this clause 9, returns will only be accepted provided that: (a) the Patient has complied with the provisions of clause 9.1; and (b) the Dentist has agreed that the Goods are defective; and (c) the Goods are returned within a reasonable time at the Patient’s cost (if that cost is not significant); and (d) the Goods are returned in as close a condition to that in which they were delivered as is possible.

9.8 If the Patient is not a consumer within the meaning of the CCA, the Dentist’s liability for any defective Services or Incidental Items is: (a) limited to the value of any express warranty or warranty card provided to the Patient by the Dentist at the Dentist’s sole discretion; (b) otherwise negated absolutely. 

9.9 Notwithstanding clauses 9.1 to 9.7 but subject to the CCA, the Dentist shall not be liable for any defect or damage which may be caused or partly caused by or arise as a result of: (a) the Patient failing to properly maintain or store any Incidental Items;  (b) the Patient using the Incidental Items for any purpose other than that for which they were designed;  (c) the Patient continuing to use any Incidental Item after any defect became apparent or should have become apparent to a reasonably prudent operator or user;  (d) interference with the Services by the Patient or any third party without the Dentist’s prior approval; (e) the Patient failing to follow any instructions or guidelines provided by the Dentist; (f) fair wear and tear, any accident, or act of God. 

10. Default and Consequences of Default

10.1 Interest on overdue invoices shall accrue daily from the date when payment becomes due, until the date of payment, at a rate of two and a half percent (2.5%) per calendar month (and at the Dentist’s sole discretion such interest shall compound monthly at such a rate) after as well as before any judgment.

10.2 If the Patient owes the Dentist any money the Patient shall indemnify the Dentist from and against all costs and disbursements incurred by the Dentist in recovering the debt (including but not limited to internal administration fees, legal costs on a solicitor and own client basis, the Dentist’s collection agency costs, and bank dishonour fees) The patient consents to recovering any overdue debts from any credit card facility the patient has previously supplied in the event that the patient has not provided other means of payment for services rendered.

10.3 Without prejudice to any other remedies the Dentist may have, if at any time the Patient is in breach of any obligation (including those relating to payment) under these terms and conditions the Dentist may suspend or terminate the supply of Services to the Patient. The Dentist will not be liable to the Patient for any loss or damage the Patient suffers because the Dentist has exercised its rights under this clause.

10.4 Without prejudice to the Dentist’s other remedies at law the Dentist shall be entitled to cancel all or any part of any order of the Patient which remains unfulfilled and all amounts owing to the Dentist shall, whether or not due for payment, become immediately payable if: (a) any money payable to the Dentist becomes overdue, or in the Dentist’s opinion the Patient will be unable to make a payment when it falls due;  (b) the Patient becomes insolvent, convenes a meeting with its creditors or proposes or enters into an arrangement with creditors, or makes an assignment for the benefit of its creditors; or (c) a receiver, manager, liquidator (provisional or otherwise) or similar person is appointed in respect of the Patient or any asset of the Patient.

11. Cancellation

11.1 The Dentist may cancel any contract to which these terms and conditions apply or cancel delivery of Services at any time before the Services are commenced by giving written notice to the Patient. On giving such notice the Dentist shall repay to the Patient any money paid by the Patient for the Services. The Dentist shall not be liable for any loss or damage whatsoever arising from such cancellation.

11.2 In the event that the Patient cancels delivery of the Services the Patient shall be liable for any and all loss incurred (whether direct or indirect) by the Dentist as a direct result of the cancellation (including, but not limited to, any loss of profits).

12. Privacy Act 1988

12.1 The Patient agrees for the Dentist to obtain from a credit reporting agency a credit report containing personal credit information about the Patient in relation to credit provided by the Dentist.

12.2 The Patient agrees that the Dentist may exchange information about the Patient with those credit providers either named as trade referees by the Patient or named in a consumer credit report issued by a credit reporting agency for the following purposes: (a) to assess an application by the Patient; and/or (b) to notify other credit providers of a default by the Patient; and/or (c) to exchange information with other credit providers as to the status of this credit account, where the Patient is in default with other credit providers; and/or (d) to assess the creditworthiness of the Patient.

13. The Patient understands that the information exchanged can include anything about the Patient’s creditworthiness, credit standing, credit history or credit capacity that credit providers are allowed to exchange under the Privacy Act 1988.

13.1 The Patient consents to the Dentist being given a consumer credit report to collect overdue payment on commercial credit (Section 18K(1)(h) Privacy Act 1988).

13.2 The Patient agrees that personal credit information provided may be used and retained by the Dentist for the following purposes (and for other purposes as shall be agreed between the Patient and Dentist or required by law from time to time): (a) the provision of Services; and/or (b) the marketing of Services by the Dentist, its agents or distributors; and/or (c) analysing, verifying and/or checking the Patient’s credit, payment and/or status in relation to the provision of Services; and/or (d) processing of any payment instructions, direct debit facilities and/or credit facilities requested by the Patient; and/or (e) enabling the daily operation of Patient’s account and/or the collection of amounts outstanding in the Patient’s account in relation to the Services.

13.3 The Dentist may give information about the Patient, including any audio and video recordings obtained during, before or after the patient’s visit, to a credit reporting agency for the following purposes: (a) to obtain a consumer credit report about the Patient; (b) allow the credit reporting agency to create or maintain a credit information file containing information about the Patient.

13.4 The information given to the credit reporting agency may include:

(a) personal particulars (the Patient’s name, sex, address, previous  addresses, date of birth, name of employer and driver’s licence number);

(b) details concerning the Patient’s application for credit or commercial credit and the amount requested;

(c) advice that the Dentist is a current credit provider to the Patient; 

(d) advice of any overdue accounts, loan repayments, and/or any outstanding monies owing which are overdue by more than sixty (60) days, and for which debt collection action has been started; 

(e) that the Patient’s overdue accounts, loan repayments and/or any outstanding monies are no longer overdue in respect of any default that has been listed;

(f) information that, in the opinion of the Dentist, the Patient has committed a serious credit infringement (that is, fraudulently or shown an intention not to comply with the Patient’s credit obligations);

(g) advice that cheques drawn by the Patient for one hundred dollars ($100) or more, have been dishonoured more than once;

(h) that credit provided to the Patient by the Dentist has been paid or otherwise discharged.

14. General

14.1 The failure by the Dentist to enforce any provision of these terms and conditions shall not be treated as a waiver of that provision, nor shall it affect the Dentist’s right to subsequently enforce that provision. If any provision of these terms and conditions shall be invalid, void, illegal or unenforceable the validity, existence, legality and enforceability of the remaining provisions shall not be affected, prejudiced or impaired.

14.2 These terms and conditions and any contract to which they apply shall be governed by the laws of the state in which the Dentist has its principal place of business, and are subject to the jurisdiction of the courts in that state. 

14.3 Subject to clause 9 the Dentist shall be under no liability whatsoever to the Patient for any indirect and/or consequential loss and/or expense (including loss of profit) suffered by the Patient arising out of a breach by the Dentist of these terms and conditions (alternatively the Dentist’s liability shall be limited to damages which under no circumstances shall exceed the Price of the Services).

14.4 The Patient shall not be entitled to set off against, or deduct from the Price, any sums owed or claimed to be owed to the Patient by the Dentist nor to withhold payment of any invoice because part of that invoice is in dispute.

14.5 The Dentist may license or sub-contract all or any part of its rights and obligations without the Patient’s consent.

14.6 The Patient agrees that the Dentist may amend these terms and conditions at any time. If the Dentist makes a change to these terms and conditions, then that change will take effect from the date on which the Dentist notifies the Patient of such change. The Patient will be taken to have accepted such changes if the Patient makes a further request for the Dentist to provide Services to the Patient. 

14.7 Neither party shall be liable for any default due to any act of God, war, terrorism, strike, lock-out, industrial action, fire, flood, storm or other event beyond the reasonable control of either party.

15. Acknowledgement of Risks

15.1 The patient acknowledges that all dental procedures carry inherent risk, and has read and understood the following general risks for commonly performed procedures. This is not a list of all risks for each applicable procedure, and any individual risks need to be discussed with the dentist. The patient consents to the procedures listed below after weighing the listed risks against the benefits of the procedure. The patient undertakes to ask any further relevant questions and address concerns with the dentist prior to proceeding with any of the listed procedures.

15.2Implant treatment: Nature and Purpose of the Procedure: The placement of the titanium implant(s) in the jaw will serve as a tooth replacement/anchor to stabilize a bridge or denture. I understand that the bridge/crown/denture is another procedure that will be placed at a later date and the fees are separate from the implant fee. The implant may be covered underneath your gum for a few months and may not get the restoration until later.

Alternatives to a Dental Implant: The alternative treatments include no treatment at all, bridge, partial denture or complete denture depending on your clinical situation. Risks and Complications: I have been informed that there are risks and complications that can arise that include but are not limited to: Infection, implant failure, Additional procedures need, tissue discoloration/bruising, Injury to adjacent teeth, sinus penetration, Gums recede exposing implant, prolonged/permanent numbness, Bone/jaw fractures, scar on gums, Longer time until final crown/bridge/denture is delivered, Swelling of facial structures, bruising No Guarantee of treatment results: I understand that there is no way to accurately predict the healing of any particular patient including the final height of the gums, and that there has been no guarantee given. No Guarantee of implant success: I understand that there is no way to accurately predict the success of the implant integration, and that there is no guarantee given. Importance of patient compliance: I understand that meticulous oral hygiene must be maintained and that smoking, alcohol, and improper diet practices must be avoided. If I fail to do so, bone healing/implant integration may be slowed or the implant may fail. Periodic Checkups: I understand that periodic cleanings and exams are very important to the success of the implant. Any bite changes or even slight looseness in the crown or implant must be reported immediately as it will not return to normal and the implant may fail. Bone Augmentation; I voluntarily consent for bone augmentation and modification between the implants to be done at the same time as implant placement. In my case, I understand that there is not enough bone in the upper molar area and a procedure called a SINUS LIFT is required.  It involves lifting of sinus cavity in my upper jaw and placing bone graft to support the implant.  I further understand that possible prolonged symptoms of sinusitis may occur requiring certain medications. 15.3 Teeth removal: Removal of any teeth including Wisdom teeth removal may involve certain risks. Numbness or altered sensation An impacted wisdom tooth may be close to nerves or touching a major nerve.  When the tooth is removed the nerve may become bruised causing numbness, tingling and loss of feeling in teeth, gums, cheeks, lips, chin, tongue and around the upper and lower jaw.  If the nerve is damaged during surgery it will usually heal within four weeks.  In some cases complete healing of the nerve may take between six to eighteen months.  Very rarely the nerve may not heal completely and numbness or an altered sensation may remain permanently. Dry socket Once a tooth has been removed a blood clot will form over the bone which will allow the wound to heal and relieve pain.  If the blood clot is washed away or dissolves, bone will become exposed resulting in throbbing pain, this is called a dry socket.  A dry socket is easily treated by the dentist and will require antibiotics. Difficulty opening mouth Pain and discomfort to open the mouth are common after extractions.  Opening the mouth will become easier over a few days once the swelling has subsided. Excessive bleeding Very rarely, haemorrhage may occur.  This may be caused by too much exertion or vomiting and can generally be stopped by applying pressure to the wound.  It is most important that you inform us if you have had any problems with bleeding in the past. Sinus problems The roots of upper molar teeth are very close to the sinus cavity.  In some cases when removing a tooth the sinus cavity may be opened, this will usually heal quite quickly and without infection.  If infection does occur further treatment may be required. Vomiting Some people may vomit when recovering from the effects of anaesthetic, this only occurs when a patient has had a general anaesthetic in hospital. Fever After surgery you may have an elevated temperature, this should return to normal within 24 hours, however if your temperature remains elevated it may be a sign of infection in which case it is best to contact us. I have read the above information and have been informed of the risks associated and give permission for the procedure.  I will not hold him/her or his/her staff accountable for any side effects that may occur post surgery. 15.4Crown and bridge treatment. I understand that dental treatment requiring CROWNS and/or FIXED BRIDGEWORK includes certain risks and possible unsuccessful results. I agree to assume those risks, possible unsuccessful results and/or failure associated with, but not limited to the following: (Even though care and diligence is exercised in the treatment of conditions requiring crowns and bridgework and fabrication of same, there are no promises or guarantees of anticipated results or the longevity of the treatment). Reduction of tooth structure: In order to replace decayed or otherwise traumatized teeth, it is necessary to modify the existing tooth or teeth so that crowns (caps) and/or bridges may be placed upon them. Tooth preparation will be done as conservatively as practical. In preparation of teeth, anesthetics are usually needed. At times there may be swelling, jaw muscle tenderness or even a resultant numbness of the tongue, lips, teeth, jaws and/or facial tissues which is usually temporary, or rarely, permanent. Sensitivity of teeth: Often, after the preparation of teeth for the reception of either crowns or bridges, the teeth may exhibit sensitivity. It may be mild to severe. This sensitivity may last only for a short period of time or may last or much longer periods. If it is persistent, notify us inasmuch as this sensitivity may be from some other source. Crowned or bridge abutment teeth may require root canal treatment: Teeth after being crowned may develop a condition known as pulpitis or pulpal degeneration. The tooth or teeth may have been traumatized from an accident, deep decay, extensive preparation, or other causes. It is often necessary to do root canal treatments in these teeth. If teeth remain too sensitive for long periods of time following crowning, root canal treatment may be necessary. Infrequently, the tooth (teeth) may abscess or otherwise not heal which may require root canal treatment, root surgery, or possibly extraction. Breakage: Crown and bridges can chip or break. Many factors could contribute to this situation such as chewing excessively hard materials, changes in biting forces, traumatic blows to the mouth, etc. Unobservable cracks may develop in crowns from these causes, but the crowns/bridges may not actually break until chewing soft foods or possibly for no apparent reason. Breakage or chipping seldom occurs due to defective materials or construction unless it occurs soon after placement. Uncomfortable or strange feeling: This may occur because of the differences between natural teeth and the artificial replacements. Most patients usually become accustomed to this feeling in time. In limited situations, muscle soreness or tenderness of the jaw joints (TMJ) may persist for indeterminable periods of time following placement of the prosthesis. Esthetics or appearance: Patients will be given the opportunity to observe the appearance of crowns or bridges in place prior to final cementation. The crown/bridge is only cemented in when the patient feels satisfied with the result. Longevity of crowns and bridges: There are many variables that determine “how long” crowns and bridges can be expected to last. Among these are some of the factors mentioned in preceding paragraphs. Additionally, general health, good oral hygiene, regular dental checkups, diet, etc. can affect longevity. Because of this, no guarantee can be made or assumed to be made. It is the patient’s responsibility to seek attention from the dentist should any undue or unexpected problems occur: The patient must diligently follow any and all instructions, including the scheduling and attending all appointments. Failure to keep the cementation appointment can result in failure of the crown/bridge to fit properly and an additional fee may be assessed. 15.5Root canal treatment: I understand root canal treatment is a procedure to retain a tooth which may otherwise require extraction. Although root canal therapy has a very high degree of clinical success, it is still a biological procedure, so it cannot be guaranteed.  Failure to follow this recommendation will most likely result in: The loss of the tooth; Bone destruction due to an abscess; Possible systemic (affecting the whole body) infection. A certain percentage of (5 – 10%) of root canals fail, and they may require retreatment, periapical surgery or even extraction. During instrumentation of the tooth, an instrument may separate and lodge permanently in the tooth or an instrument may perforate the root wall. Although this rarely occurs, such an occurrence could cause the failure of the root canal and the loss of the tooth. When making an access (opening) through an existing crown or placing a rubber dam clamp, damage could occur and a new crown would be necessary after endodontic therapy. Successful completion of the root canal procedure does not prevent future tooth decay or fracture. Temporary fillings are usually placed in the tooth immediately after the root canal treatment. Teeth which have had root canal treatment will require a permanent (outside) restoration. This may involve a filing or more extensive restorative work (pins, post, crown buildup, crown) depending on the clinical status of the tooth. There are risks involved in administration of anesthetics, analgesics (pain medication) and antibiotics. I will inform the doctor of any previous side-effects or allergies. 15.6Resin composite Restorations: I UNDERSTAND that the treatment of my dentition involving the placement of composite resin fillings which may be more aesthetic in appearance that some of the conventional materials which have been traditionally used, such as silver amalgam or gold, may entail certain risks. There is also the possibility of failure to achieve the results which may be desired or expected. I agree to assume those risks which may occur even though care and diligence will be exercised by my treating dentist in rendering this treatment. These risks include possible unsuccessful results and/or failure which are associated with, but not limited to the following: Sensitivity of Teeth: Often after preparation of teeth for the placement of any restoration, the prepared teeth may exhibit sensitivity which may be mild to severe. The sensitivity may last only for a short period of time or may last for much longer periods of time. If such sensitivity is persistent or lasts for much extended periods of time, I agree to notify the dentist inasmuch as this may be a sign of more serious problems. Risk of Fracture: Inherent in the placement of any restoration is the possibility of the creation of small fracture line in tooth structure. Sometimes these fractures may not be apparent at the time of removal of tooth structure and/or the previous filling and placement or replacement, but may manifest at a later time. Necessity of Root Canal Therapy: When fillings are placed or replaced, the preparation of the teeth for fillings often necessitates the removal of tooth structure adequate to ensure that the diseased or otherwise compromised tooth structure provides sound tooth structure for placement of the restoration. At times, this may lead to exposure or trauma to underlying pulp tissue. Should the pulp not heal, which often times is exhibited by extreme sensitivity or possible abscess, root canal treatment or extraction may be required. Injury to the Nerves: There is a possibility of injury to the nerves of the lips, jaws, teeth, tongue, or other oral or facial tissues from any dental treatment, particularly those involving the administration of local anesthetics. The resulting numbness which may occur is usually temporary, but in rare instances could be permanent. Aesthetics or Appearance: Effort will be made to closely approximate the natural tooth color. However, due to the fact that there are many factors which affect the shades of teeth, it may not be possible to exactly match the tooth coloration. Also, over a period of time, the composite fillings, because of mouth fluids, different foods eaten, smoking, etc. may cause the shade to change. The dentist has no control over these factors. Breakage, Dislodgement or Bond Failure: Due to extreme masticatory pressures or other traumatic forces, it is possible for composite resin fillings or aesthetic restorations bonded with composite resins to be dislodged or fractured. The resin-enamel bond may fail, resulting in leakage and recurrent decay. The dentist has no control over these factors. New Technology and Health Issues: Composite resin technology continues to advance but some materials yield disappointing results over time and some fillings may have to be replaced by better, improved materials. Some patients believe that having metal fillings replaced with composite fillings will improve their general health. This notion has not been proven scientifically and there are no promises or guarantees that the removal of silver fillings and the subsequent replacement with composite fillings will improve, alleviate, or prevent any current or future health condition. I understand that it is my responsibility to notify this clinic should any undue or unexpected problems occur or if I experience any problems relating to the treatment rendered or the services performed. 15.7 Dentures: I UNDERSTAND that the process of fabricating and fitting PARTIAL DENTURES and/or COMPLETE ARTIFICIAL DENTURES includes risks and possible failures. Though the utmost care and diligence is exercised in preparation for and fabrication of immediate prosthetic appliances, there is the possibility of failure with patients not adapting to the new dentures. I agree to assume those risks and possible failures associated with but not limited to the following: Failure of Immediate Complete Dentures: Many variables can contribute such as: (1) gum tissues which cannot bear the pressure placed upon them resulting in excessive tenderness/sore spots, especially during healing after extraction and denture placement; (2) jaw ridges which may not provide adequate support and/or retention as shrinkage occurs following extractions; (3) musculature in the tongue, floor of the mouth, cheeks etc., which may not adapt and be able to accommodate the new artificial appliances; (4) excessive gagging reflexes as the mouth adapts to the new dentures; (5) excessive saliva or excessive dryness of mouth; (6) general psychological and/or physical problems interfering with success. Failure of Removable Partial Dentures: Many variables may contribute to the successful utilizing of immediate partial dentures (removable bridges). As well as problems related to failure of complete dentures, in addition: (1) natural teeth to which partial teeth are anchored (abutment teeth) may become tender, sore and/or mobile as support of the ridge changes during healing; (2) abutment teeth may decay or erode around the clasps or attachments; (3) tissues supporting the abutment teeth may fail after healing is complete. Breakage: Due to the types of materials necessary in the construction of these appliances, breakages may occur even though the materials used were not defective. Factors which may contribute to breakage are: (1) chewing on foods/objects which are excessively hard; (2) gum tissue shrinkage which causes excessive pressures to be exerted unevenly on the dentures, especially as the tissues heal and change; (3) cracks which may be unnoticeable and which occurred previously from causes such as those mentioned in (1) and (2); (4) use of porcelain teeth as part of the denture, or the dentures having been dropped or damaged previously in the event of the dentures are relined. The above factors listed may also cause extensive denture tooth wear or chipping. Loose Dentures: Immediate complete dentures are normally less secure as healing progresses and the ridge changes. Dentures themselves do not change unless subjected to extreme heat or dryness. After several months once healing is complete, the dentures will generally be quite loose and a reline or even rebase (replacement of all tissue colored material supporting the teeth) will become necessary. During the healing process some chairside relines may be performed, but eventually a laboratory processed reline or rebase will be necessary. A fee will be charged for relining or rebasing dentures and I understand that the fee for immediate dentures does not cover this reline or rebase fee. Immediate partial dentures may become loose for the same reasons listed. Allergies to Denture Materials: Infrequently the oral tissues may exhibit allergic symptoms to the materials used in construction of either partial or full dentures. Failure of Supporting Teeth and/or Soft Tissues: Natural teeth supporting immediate partial dentures may fail due to decay; excessive trauma; gum tissue/bony tissue problems. This may necessitate extraction. The supporting soft tissues may fail due to many problems including poor dental or general health. Uncomfortable or Strange Feeling: This may occur because of the differences between natural teeth and the artificial dentures. Most patients usually become accustomed to this feeling in time, however, some patients have great difficulty adapting to complete dentures. Esthetics or Appearance: Patients will be given the opportunity to observe the anticipated appearance of the dentures prior to processing. It is the patient’s responsibility to seek attention when problems occur and do not lessen in a reasonable amount of time; also, to be examined regularly to evaluate the tissue response to the dentures during healing, condition of the gums, and the patients oral health. 15.8Veneers I have been informed that complications might include, but are not limited to: Some of the enamel from my teeth will be removed. I give my consent to use local anesthetic and take x-rays as required. I will have temporaries on my teeth until such time as my veneers are delivered, which may break and be dislodged and require replacement at my expense. Some of my opposing teeth may be altered and my occlusion (bite) may be altered. I may be required to wear a mouth guard/splint to bed each night if advised by the dentist. Some of my teeth may remain sensitive and root canal treatment may be required. Should teeth fracture during preparation, crowns may be required. There may be chipping, fracture and discoloration as time progresses, which might not be reparable. Replacement at my expense may be required. There is no guarantee as to how long the veneers will last and I have been given hygiene instructions. Once I have approved the shade (color) of the veneers and they are delivered, if I wish a change, it will be at my expense.