GENERAL CONSENT FORM

Dear Patient, Please read the information given below. By reading and signing this information, you will have information about the treatments that will be applied to you or your child. Learning the benefits and risks of treatment planning will make you satisfied at the end of the treatment. Wishing you a healthy and happy life. During the treatments, limited numbing is applied to provide pain control. When necessary, first of all, the gingiva or the inner part of the cheek is anesthetized with a topical anesthetic agent (spray). When the area becomes numb, the anesthetic liquid is injected with a syringe and the tooth and the area are numbed for a while. Allergic reactions, loss of sensation, bleeding, temporary muscle spasms, temporary facial paralysis may be seen in patients, although rare, after local anesthesia application. Local anesthesia is a successful application as long as there are no anatomical differences or acute infections in the region. The area where local anesthesia is applied is numb for about 2-4 hours. For this reason, it is not recommended to eat and drink until the numbness subsides, in order to avoid wounds on the cheeks and lips due to the bite. After 2-4 hours, the effect of anesthesia disappears. During your treatments, biopsy may be required for further examination. Take care to be faithful to your appointments and to arrive on time so that our health institution, its order and treatment program are not disrupted. If you cannot come, cancel your appointment 24 hours in advance. Tooth extraction; Whether it is a difficult or routine extraction, it is a surgical procedure and is irreversible. As with any surgical procedure, there are some risks. These risks can be listed as but not limited to the following: 1. Swelling and/or redness, discomfort in the surgical area, 2. Redness and cracking due to stretching at the corners of the mouth, 3. Development of infection and delayed healing of the wound, 4. Dry socket; jaw pain that begins a few days after surgery, often due to inadequate care; It is more common in lower jaw extractions, especially in wisdom teeth. 5. Damage to the adjacent tooth, especially in the presence of large fillings and crowns, 6. Loss of sensation or decreased sensation in the gums, lip, tongue, teeth and jaw tip. It can be seen especially in teeth with roots close to nerves, such as wisdom teeth. Numbness almost always returns to normal, but very rarely it can be permanent. 7. Trismus; It is a limitation in opening the mouth due to inflammation or swelling. 8. Bleeding-severe bleeding is not common. But bleeding in the form of leakage continues for several hours. 9. Sharp corners and bony steps may occur in the shooting cavities after extraction. These are corrected with a new surgical intervention. 10. Incomplete removal of root fragments. Sometimes small pieces of root can be left in order not to damage important formations such as sinuses or nerves. 11. Sinus relationship; the roots of the maxillary posterior teeth are very close to the sinuses, and in some cases, root fragments may escape into the sinus or an opening may form between the sinuses and the mouth; These situations need special attention. 12. Jaw fractures; Although it is very rare, it is possible to occur in difficult and deeply impacted tooth extractions. I have understood that root canal treatment is a procedure to save the tooth from being pulled out. I learned that although root canal treatment has very successful clinical results, it is a treatment that can never be guaranteed because it is a biological process. I have understood that the small instruments used in the root canal during the treatment have a slight chance of breaking and this may adversely affect the success of the treatment. I was informed that in some cases, especially in teeth with periapical lesions, if there is no improvement after root canal treatment, repeat root canal treatment, surgical intervention and sometimes tooth extraction may be necessary.

GENERAL CONSENT FORM

Dear Patient, Please read the information given below. By reading and signing this information, you will have information about the treatments that will be applied to you or your child. Learning the benefits and risks of treatment planning will make you satisfied at the end of the treatment. Wishing you a healthy and happy life. During the treatments, limited numbing is applied to provide pain control. When necessary, first of all, the gingiva or the inner part of the cheek is anesthetized with a topical anesthetic agent (spray). When the area becomes numb, the anesthetic liquid is injected with a syringe and the tooth and the area are numbed for a while. Allergic reactions, loss of sensation, bleeding, temporary muscle spasms, temporary facial paralysis may be seen in patients, although rare, after local anesthesia application. Local anesthesia is a successful application as long as there are no anatomical differences or acute infections in the region. The area where local anesthesia is applied is numb for about 2-4 hours. For this reason, it is not recommended to eat and drink until the numbness subsides, in order to avoid wounds on the cheeks and lips due to the bite. After 2-4 hours, the effect of anesthesia disappears. During your treatments, biopsy may be required for further examination. Take care to be faithful to your appointments and to arrive on time so that our health institution, its order and treatment program are not disrupted. If you cannot come, cancel your appointment 24 hours in advance. Tooth extraction; Whether it is a difficult or routine extraction, it is a surgical procedure and is irreversible. As with any surgical procedure, there are some risks. These risks can be listed as but not limited to the following: 1. Swelling and/or redness, discomfort in the surgical area, 2. Redness and cracking due to stretching at the corners of the mouth, 3. Development of infection and delayed healing of the wound, 4. Dry socket; jaw pain that begins a few days after surgery, often due to inadequate care; It is more common in lower jaw extractions, especially in wisdom teeth. 5. Damage to the adjacent tooth, especially in the presence of large fillings and crowns, 6. Loss of sensation or decreased sensation in the gums, lip, tongue, teeth and jaw tip. It can be seen especially in teeth with roots close to nerves, such as wisdom teeth. Numbness almost always returns to normal, but very rarely it can be permanent. 7. Trismus; It is a limitation in opening the mouth due to inflammation or swelling. 8. Bleeding-severe bleeding is not common. But bleeding in the form of leakage continues for several hours. 9. Sharp corners and bony steps may occur in the shooting cavities after extraction. These are corrected with a new surgical intervention. 10. Incomplete removal of root fragments. Sometimes small pieces of root can be left in order not to damage important formations such as sinuses or nerves. 11. Sinus relationship; the roots of the maxillary posterior teeth are very close to the sinuses, and in some cases, root fragments may escape into the sinus or an opening may form between the sinuses and the mouth; These situations need special attention. 12. Jaw fractures; Although it is very rare, it is possible to occur in difficult and deeply impacted tooth extractions. I have understood that root canal treatment is a procedure to save the tooth from being pulled out. I learned that although root canal treatment has very successful clinical results, it is a treatment that can never be guaranteed because it is a biological process. I have understood that the small instruments used in the root canal during the treatment have a slight chance of breaking and this may adversely affect the success of the treatment. I was informed that in some cases, especially in teeth with periapical lesions, if there is no improvement after root canal treatment, repeat root canal treatment, surgical intervention and sometimes tooth extraction may be necessary.