C. For Treatment – Cleaning of Teeth and Gums
This is my consent for Dr. Sayre-Carstairs and/or her hygienists to clean my teeth. I understand that there are possible side effects to this care and they vary depending on the procedure to be completed ie: Non Surgical Hygiene Therapy, Deep Cleaning (scaling/root planning) and use of a Dental Laser in conjunction with treatments. The side effects include, but are not limited to, tooth/root sensitivity or mobility. There may be recession of the gums. Existing dental work may become damaged. The nerve of the tooth may flare up requiring a root canal later on. The muscles of the face or neck may spasm and require further evaluation and/or treatment. If anesthesia is to be used, swelling, bruising and prolonged numbness may result. Infection of any area of the mouth is a possibility. All treatments will be discussed with me prior to execution and I will have the opportunity to discuss my care with Dr. Sayre-Carstairs and/or her staff at any time.