Tooth Extraction Surgical Acknowledgement and Consent

While we try to offer the best possible treatment outcomes, some complications may arise during or after extraction / oral surgery. These are including but not limited to: inflammation, discomfort, infection, bleeding, opening of sinus, dry socket and temporary or permanent numbness of the lower lip, chin, gum, tongue or ceiling of mouth.

Depending on difficulty of case, we may require incision, sectioning and / or suturing which can be varied from one tooth to the other. In some cases bone grafting may be required. In such a case, the source of bone can be from other parts of the mouth, in synthetic form, from human sources, or from animal sources. We will advise you if it becomes needed and if so, which type would fit the best for your specific case.

You should advise us about any history of health issues, medication use, allergy and/or intolerance to any antibiotic. Diarrhea, upset stomach and change in normal flora of digestive system are common when taking some antibiotics. In such cases, contact us or your family doctor immediately. Some antibiotics may also interfere with the effect of oral contraceptive pills. Taking pro-biotic yogurt in case of taking antibiotic is recommended.

To reduce the post operative problems patients should follow these instructions;

• In case of surgery, place an ice pack wrapped in a towel around the area of surgery from outside for 10 minutes on and 10 minutes off. Do this for 1-2 hours if possible. This will reduce swelling and cause less pain.

• No brushing, rinsing, spitting, or using a straw until the next day following surgery/extraction. You may drink room temperature liquids using a normal cup.

• Do not take Aspirin products – They are blood thinners and will induce bleeding. In case of pain, please use Advil or Tylenol only

• No physical activities or exercise for 48 hours. Please rest.

• Bite on gauze for one hour to stop bleeding. Remove and check site. If still bleeding, repeat it with extra gauzes provided.

• High temperature or hot and spicy foods and drinks should be avoided for the first 48 hours. Any cold foods or drinks such as milk, yogurt and shakes are good.

• Do not smoke or drink alcohol for 48 hours. Use of alcohol until you finish antibiotics, if prescribed, is prohibited.

• Starting on the next day, you can brush your teeth normally but do not brush surgical site. To keep the surgical site clean, starting the next day, rinse every couple of hours with salty water. ( Normal Saline 9 grams in one litre)

I have read the above, and am aware of the possible complications/risk factors related to root surgery / extraction of tooth/ teeth. I understand that there is no warranty or guarantee as to any result. I am further advised that I can get additional explanations of risks before or during the progress of my treatment merely by asking. I understand that all alternative treatment options such as possible treatment options to save the tooth and option to do no treatment with all pros and cons was explained to me in a clear way and all my questions were answered.