Invisalign Consent

What is Invisalign?

Invisalign is an orthodontic system using clear aligners as opposed to conventional metal braces. A series of light, clear plastic removable aligners move your teeth in gradual stages from the original position of your teeth to a more aligned and aesthetically pleasing position.

After a thorough dental examination including X-rays and digital scans of your teeth, a series of bespoke aligners are manufactured after careful and precise planning of intended tooth movements by the dentist.

These are custom fitted to your mouth and the treatment is then monitored by your dentist from start to finish.

Benefits

• Invisalign aligners offer an aesthetic alternative to conventional braces.
• Aligners are nearly invisible so many people won’t realise you are in treatment.
• Treatment plans can be visualised through the ClinCheck software.
• Aligners allow for normal brushing and flossing tasks that are generally impaired by conventional braces.
• Aligners do not have the metal wires or brackets associated with conventional braces.
• The wearing of aligners may improve oral hygiene habits during treatment.
• Invisalign patients may notice improved periodontal (gum) health during treatment.

This patient agreement contains vital information regarding your treatment

By signing to this patient agreement, you acknowledge that you have reviewed and consent to all the below information.

I hereby consent to the following:

• The procedure explained to me by the dentist listed on this document.
• The utilization of the appliance, attachment, and Interproximal Reduction (if deemed appropriate).

I understand the following:

• I have been provided with comprehensive information regarding the treatment's nature and any potential complications.
• Recognize that this is a cosmetic procedure, and the maintenance of my oral health depends on my compliance with the dentist's instructions.
• Understand that, since this is a cosmetic procedure, I am aware of its limitations and have been informed about alternative options.
• Any additional procedures, beyond the treatment outlined here, will only be performed if they are deemed necessary for my best interests, can be clinically justified, and will be explained to me before their execution.

I have:

• Informed the dentist of my existing medical conditions and any known infectious diseases.
• Disclosed any current or recent medication I have been taking.

Additional Notes:

• If there are any aspects of the explanation that you find unclear or if you desire more information, please do not hesitate to ask the dentist or the treatment coordinator.
• Please verify that all the information on this form is accurate. If it is, and you have comprehended the explanation letter, kindly sign the form.

Patient Responsibilities

• To ensure you clearly articulate your desired smile improvements.
• To maintain your oral health, please adhere to the brushing and oral hygiene instructions provided. Aim to schedule a hygiene visit either with us or your regular hygienist every 4 months and continue to arrange routine dental examinations every 6 months to uphold your oral well-being.
• Inform the dentist if you've experienced any trauma to a tooth at any point. For instance, if you had an incident where you injured a tooth in your youth, it may have enduring consequences.
• Attendance - Please attend all appointments punctually, and if you need to cancel, provide a minimum of 72hours' notice; otherwise, a cancellation fee will be incurred.
• Treatment Duration - The treatment timeline will be determined by the clinician but can also be influenced by external factors, such as your compliance with wearing aligners and the response of stubborn teeth. The duration is not guaranteed.
• Eating and Drinking - Refrain from eating while wearing removable appliances, as this can harm your teeth and aligners/retainers.
• Replacement of Aligners - While we will make efforts to rescan and replace lost aligners at no additional cost in exceptional cases for the first instance, subsequent losses or replacements will incur charges in accordance with our standard treatment fee guide at the time.
• Cancellation of Treatment - By signing this consent, you acknowledge that aligners will be prescribed and ordered. From this point onward, or at any point during treatment, the cost becomes non-refundable, even in extenuating circumstances. The clinician cannot be held responsible for additional costs or treatment risks if you choose to discontinue treatment. The cancellation fee for Invisalign is £1,500 after aligners have been ordered.
• Payments - Once you've selected your preferred payment method, if you are spreading the treatment cost via direct debit, ensure that any missed payments are settled before your next appointment to receive your next set of aligners. In the event of the dentist being unable to treat you due to an emergency or personal reason, suitable arrangements will be made for you to be seen by another practitioner. All payments must be settled before concluding treatment.
• Other Treatment Fees - Please note that any additional dental treatments required during or after your Invisalign treatment, apart from Invisalign itself, will incur separate costs. This includes composite or edge bonding, veneers, crowns, or fillings. These procedures can be performed at our practice or another of your choosing.

- If you are unable to attend an appointment you must let the practice know within the 72-hour notice period of your appointment. Failing to let the practice know within the 48-hour notice period, or failing to attend an appointment will result in a £30 fee that will need to be paid before rebooking your next appointment. You can contact the practice via, telephone call, leaving a voice mail, or emailing your reception team.

Maintaining the alignment of your teeth following Invisalign or any orthodontic treatment requires a lifelong commitment. Neglecting to wear your retainers as prescribed, replacing them, or providing proper care can lead to your teeth shifting back to an undesired position.

Both you and your clinician will only proceed to order or fix your retainers when both parties are content with the alignment of your teeth. If you're not yet satisfied, it is crucial that you communicate this.

With our package, we include a set of removable retainers as part of your treatment. After this period, the financial responsibility for maintaining the alignment of your teeth will be yours as the patient, and you'll need to wear them for 12 hours per day at home. Immediately after treatment, we usually recommend wearing them full-time for three months.

Retainers are specially designed to keep your teeth in their corrected positions after the removal of braces or the completion of your orthodontic treatment. They are custom-made devices used to maintain tooth alignment following surgery or any other method of realigning teeth.

• Soreness:
  • Dental tenderness when switching to the next aligner in the series
  • Gums, lips or cheeks may be irritated, particularly when placing and removing aligners
  • The bite will be changing throughout the course of treatment and may result in temporary discomfort
• Inability to achieve an ideal class 1 incisor, canine and molar relationship:
  • This is referred to as the ideal way your teeth should fit together (‘ideal occlusion’) and what an orthodontist would aim to achieve
  • This is unlikely to have an impact on the end satisfaction of the treatment outcome based on the cosmetic concerns you expressed.

• After straightening the teeth, the biting edges of your front teeth may appear jaded and uneven due to previous wear of them throughout your lifetime:
  • There are options that will be discussed to correct this cosmetic issue.
• The aligners may temporarily affect speech and may result in a lisp for the first 2 weeks when getting use to
• Attachments are tooth-coloured “buttons” that may be bonded to one or more teeth during the course of treatment to facilitate tooth movement:
  • This may make it more noticeable that you are in treatment (please refer to below picture)
  • Attachments may fall off and may require to be re-bonded on

• Elongated treatment time and inability to achieve desired results. This can be affected by:
  • Failure to wear the appliances for the required number of hours per day
  • Not using the product as directed
  • Missing appointments, and erupting or atypically shaped teeth can lengthen the treatment time and affect the ability to achieve the desired results
• Teeth may move in the month or years following the end of treatment:
  • You will be provided with a set of removable retainers
  • You may want to consider additional forms of retention such as fixed retainers or Invisalign’s vivera retainers

• The formation of, or worsening of existing 'black triangle spaces':
  • Teeth which have been overlapped for long periods of time are more likely to form black triangles once aligned as they may be missing the gingival tissue between the teeth
  • Pre-existing recession or recession after orthodontic treatment of the gums can cause this. Recession can happen naturally during life, but can be exacerbated by gum disease and vigorous brushing
  • Having triangular shaped teeth

• Gum Recession:
  • The bone-gum relationship around teeth is always dependent upon whether there is enough bone to support the gum tissue properly.
  • Many times when very crowded teeth are straightened there is a lack of bone and supporting gum tissues surrounding the teeth. This can cause recession which may happen during or after orthodontic treatment.
  • However it is found people tend to brush their teeth more often and vigorously than before when going through orthodontic treatment causing the gums recede at a faster rate.
  • Any additional treatment with a periodontal specialist for this will be at additional costs to the patient.

• Root resportion - The length of the roots of the teeth may be shortened during orthodontic treatment and may become a threat to holding onto the teeth for life:
  • 0-2mm can be expected through any course of orthodontic treatment and is extremely unlikely to affect the life of the tooth
  • The risk of this is lower during short term orthodontic treatment, particular aligner therapy such as Invisalign
  • The risks are higher with more comprehensive and lengthier orthodontic treatment more common with use of traditional metal braces

• Allergic reaction to aligner coating: Allergic reactions to the Invisalign clear retainers are rare but are still possible. A few signs to look out for are :
  • Rash or skin irritations
  • Shortness of breath
• If these do occur, please contact us immediately so we can assess the situation and give you the best advice tailored to your situation
• Loss of Vitality: Vitality loss can occur before, during or after the movement in teeth. A tooth that has been traumatised from a deep filling or even a minor blow can die over a long period of time with or without tooth alignment treatment and is therefore not able to be predicted. Ways to assess if teeth are dying is that it goes a grey/brown colour. This can be easily treated with a root canal treatment and a veneer (composite or porcelain) to mask the discoloration. In worse cases, the tooth will need to be removed and treatment will have to be terminated. This is all done at an additional cost to the patient with us or another practice. Similarly, if root canal treated teeth become symptomatic during treatment, re-root canal treatment may be required at additional cost to the patient and may cause treatment to be paused or terminated. Cancellation fees would still apply.

• In rare instances, problems may also occur in the jaw joint, causing joint pain, headaches or ear problems.
• Health of the bone and gums which support the teeth may be impaired or aggravated in the presence of poor oral hygiene

In the event you should move away from our dental practice or relocate outside the UK, the treatment process will naturally need to be amended. We are able to offer a Virtual Care service and post out aligners as and when needed. This will incur an additional charge of £1,800.

Although we will be unable to carry out essential reviews, IPR or additional scans and would recommend searching for a local provider to offer this service. This service will need to be funded separately and will not be included within your treatment package. If you wish to transfer to a local Invisalign prescriber a refund will not be offered as such fees have already been paid. If you choose to terminate treatment due to relocation the full treatment becomes non-refundable even under extenuating circumstances.

Your Dentist may recommend the use of the Virtual Care software

Virtual Care is a communication tool between your Dentist and yourself. This consists of a web platform intended for Dentists and a phone application intended for Patients. The Virtual Care App, installed on your smartphone, allows you to take a set of photos of their mouth and upload them to the web platform in pre-set intervals for more in-depth and close monitoring of your Invisalign treatment.

We draw your attention to the fact that the Virtual Care App is not a clinical management solution and should only be used under the supervision of a Healthcare Professional. The information and advice provided within the Virtual Care App must in no way replace any previous advice or prescription from your Dentist.

I understand that if my Dentist has recommended the use of the Virtual care software during my treatment it is to monitor my teeth more closely without the need for more frequent appointments.

I will adhere to the monitoring schedule on the Virtual Care app and am aware failure to do so can increase the treatment length and the possibility of more aligners being needed.