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Patient information

Despite all care taken on our part, dental and/or orthodontic treatments come with certain risks. Complications may arise that in some circumstances necessitate additional dental/medical and/or orthodontic treatment measures. For dental corrections involving Aligners, ceramic restoration and additional products and services, the following risks and information should be noted:

Information and risks for Aligner treatment

The following information and risks apply to treatments involving Aligners. Depending on how the patient's individual treatment plan is set up, the following procedures may need to be performed: placement of attachments and/or other treatment aids (e.g., bite ramps, buttons, elastics) and/or space-creating measures such as stripping/slicing.

Aligners

  • Pressure is exerted on the teeth in order to change their position. This can lead to pain or discomfort, which is usually temporary. In rare cases, it may be necessary to treat the pain or carry out other treatments.

  • Wearing an Aligner can impair speech and enunciation. This is usually short-term but can also occur over a longer period of time in rare cases.

  • Wearing an Aligner can increase saliva or lead to oral dryness. Certain medications can influence and/or strengthen this effect depending on the individual. Please inform your bestsmile dentist about the medications you are taking.

  • Your actual treatment time may exceed what was estimated by your bestsmile dentist. The following factors in particular can lengthen your treatment time: not enough daily wear time (22 hours for normal Aligners and 8 to 10 hours per night for Night Aligners), not showing up for treatments and check-up appointments, not practising good oral hygiene, and wearing damaged Aligners. Having unusually shaped teeth can also extend the required treatment time. For instance, short clinical crowns can cause problems with Aligner retention and slow down or prevent the movement of the teeth.

  • Night Aligner treatment can be turned into regular Aligner treatment by your dentist at any time. Please inform your bestsmile dentist if you notice a lack of progress with your Night Aligner treatment.

  • The simulated end result is a purely visual simulation. Achieving this result heavily depends on individual factors such as sticking to the required daily wear time, showing up to your treatment and check-up appointments and practising good oral hygiene as well as the position of your teeth and the spacing between them, among other factors.

  • The following problems can occur if your oral hygiene is poor: cavities, periodontitis, decalcification (permanent marks on the teeth), and inflammation of the gums. In individual cases, there can be erosion of the tooth enamel, which involves a possible but unlikely loss of the tooth.

  • Wearing an Aligner can in some cases cause injuries and rubbing on the inside of the mouth (gums, cheeks, tongue, lips). Please get in touch with your bestsmile practice or dentist if this is the case.

  • In order to enable the teeth to shift and/or if you experience crowding (teeth that overlap each other in parts), it can be necessary to perform an interproximal enamel reduction so that there is sufficient space.

  • Taking certain medications and/or your general physical condition can cause individual variations in the Aligner treatment. Please inform your bestsmile dentist about the medications you are taking and about your general physical condition.

  • Allergic reactions to the Aligner material are not known and are very unlikely to occur but cannot be ruled out.

  • During your Aligner treatment, especially at the beginning or when switching to a new tray, you may experience increased sensitivity in your teeth and mucous membranes.

  • In isolated cases, particularly those involving severe pre-existing dental disease, wearing an Aligner can severely impair the condition of the patient's teeth, including the death or loss of a tooth, which would necessitate further treatment to maintain the dentition.

  • Wearing an Aligner can impair the quality of existing fillings, crowns and bridges. They may become loose and need to be re-cemented into place or in isolated cases replaced entirely. Please contact your bestsmile dentist before exchanging or re-affixing any fillings, crowns or bridges, as these changes can influence the fit of your Aligner.

  • While root resorptions (degradation or loss of enamel around the root area) can occur in the natural untreated dentition, they are mostly a common side effect of orthodontic treatment. Sometimes the body can repair root resorptions itself, but bigger defects can remain after treatment. Most root resorptions are so small that they are undetectable in panoramic X-ray images and are never noticeable or result in any damage. Only around 20% of patients show very small changes in their X-rays, and here they rarely become clinically relevant. Tooth loss due to root resorption is reported very rarely in the literature. However, it is theoretically possible and therefore cannot be ruled out.

  • Your Aligners may break. Aligners are more likely to break when several teeth are missing and there is a tooth gap. If your Aligner breaks, please inform your bestsmile dentist immediately so that they can organise a replacement.

  • Since Aligners are worn in the mouth, they can be fully or partially swallowed or inhaled. To reduce the risk of swallowing or inhaling your Aligner, be sure to have it checked regularly. Broken or otherwise damaged Aligners may not be worn. Please get in touch with your bestsmile practice of dentist if this is the case.

  • In rare cases, wearing an Aligner can lead to problems in the jaw joint that cause and/or worsen joint pain, headaches, ear problems, tinnitus or other symptoms. Inform your bestsmile dentist immediately if any symptoms of this kind arise.

  • The usual risks of ionizing radiation apply to X-rays of your oral cavity and surrounding structures (e.g. orthopantomogram or cephalometric X-rays).

Stripping/Slicing

  • The reduction of tooth enamel can lead to hypersensitivity of the teeth, increased predisposition to cavities and increased plaque formation, which can in rare cases necessitate further dental treatment.
  • Narrowing of the interradicular space can cause increased susceptibility to periodontal diseases, which can in rare cases necessitate further dental treatment.

Attachments and other treatment aids (e.g., bite ramps, buttons, elastics)

  • Attachments and other treatment aids can lead to temporary misalignment when biting down.

  • When removing a treatment aid that has been applied to the tooth (e.g., attachments or buttons), some healthy tooth enamel may also be removed in rare cases.

  • Since attachments and other treatment aids are attached to the teeth/placed in the mouth, patients may accidentally swallow or inhale them, either fully or partially. Please get in touch with your bestsmile practice of dentist if this is the case.

Important behavioural instructions for Aligner treatment:

  • Daily oral hygiene needs to be practised regularly and thoroughly in accordance with the instructions from your bestsmile dentist. Without further instruction from your bestsmile dentist, regular dental hygiene usually includes brushing your teeth three times per day (morning, noon, night) and using other oral hygiene products such as floss and/or mouthwash.

  • The Aligners should be worn for at least 22 hours per day. For Night Aligners, the minimum wear time is 8 to 10 hours per night.

  • Patients must attend their treatment and check-up appointments and reschedule them as soon as possible if they can't make it.

  • Any instructions from your bestsmile dentist must be followed precisely and diligently.

  • Please inform your bestsmile dentist about any medications you are taking, your general physical condition, any complications that arise and any other information that could be relevant to your treatment.


Information and risks for treatment with ceramic dental restorations

The following information and risks apply to ceramic dental restorations such as Veneers, inlays, onlays and bridges as well as full and partial crowns (also hereinafter referred to as ceramic(s)).

  • The application of ceramics requires permanently removing a thin layer of enamel, which is an irreversible procedure that can involve pain or discomfort (usually temporary). In rare cases, it may be necessary to treat the pain or carry out other treatments.

  • The procedure for removing the thin layer of enamel and applying the final ceramics is usually performed under local anaesthesia. Even though local anaesthetics allow for efficient, pain-free procedures, complications cannot be ruled out. These complications mainly include pain and bruising and in rare cases may involve nerve damage, allergic reactions (e.g., anaphylactic shock), overdose, cardiovascular events and/or additional reactions that would necessitate further medical treatment.

  • Your teeth can be especially sensitive to cold and heat while wearing temporary ceramics and in the first few weeks following the placement of the final ceramics. Therefore, when eating warm or cold food and drinks, a temporary unpleasant pain may occur. In rare cases, additional dental treatment such as endodontological interventions (e.g., root canal) may be necessary.

  • Ceramic restorations can, in isolated cases, become detached or break, which would necessitate additional treatment such as dental procedures and/or the placement of new ceramics.

  • Since ceramics are worn in the mouth, they can be fully or partially swallowed or inhaled. To reduce the risk of swallowing or inhaling, be sure to have the conditions of your ceramic components checked regularly. Broken or otherwise damaged restorations need to be inspected by a dentist immediately. Please get in touch with your bestsmile practice of dentist if this is the case.

  • Wearing ceramics can impair speech and enunciation. This is usually short-term but can, in some rare cases, occur over a longer period of time.

  • Wearing ceramics can in some cases cause injuries and rubbing on the inside of the mouth (gums, cheeks, tongue, lips). Please get in touch with your bestsmile practice or dentist if this is the case.

  • The following problems can occur if your oral hygiene isn't good enough, particularly in the area where the ceramic is attached: cavities, periodontitis, decalcification (permanent marks on the tooth), and inflammation of the gums. In rare cases, there can be erosion of the tooth enamel, which involves a possible but unlikely loss of the tooth.

  • In isolated cases, particularly those involving severe pre-existing dental disease, having ceramics can severely impair the health of the patient's teeth, which would necessitate further treatment to maintain the dentition.

  • The usual risks of ionizing radiation apply to X-rays of your oral cavity and surrounding structures (e.g. orthopantomogram or cephalometric X-ray).

Important behavioural instructions for treatment with ceramic dental restorations:

  • Daily oral hygiene needs to be practised regularly and thoroughly in accordance with the instructions from your bestsmile dentist, both during and after your treatment with ceramics. Without further instruction from your bestsmile dentist, regular dental hygiene usually includes brushing your teeth three times per day (morning, noon, night) and using other oral hygiene products such as floss and/or mouthwash.

  • Patients must attend their treatment and check-up appointments and reschedule them as soon as possible if they can't make it.

  • Any instructions from your bestsmile dentist must be precisely and diligently followed.

  • Please inform your bestsmile dentist about any medications you are taking, your general physical condition, any complications that arise and any other information that could be relevant to your treatment.

Information and risks for additional products and services

Whitening (bleaching)

  • Having your teeth bleached (whitened) can make them temporarily (or in rare cases, permanently) sensitive to warm, cold and sour food and beverages.
  • For "internal bleaching" (inside of a hollow tooth), there is the risk that your tooth will fracture during the bleaching process. This means that the hollow, unstable tooth can break and that there is a risk of (root) resorption (degradation and/or dissolution of the tooth root or enamel), especially if the root canal filling is insufficiently sealed.
  • Each round of bleaching makes the enamel slightly thinner and more porous. The roughened surface of the tooth makes it easier for bacteria and acids to attack enamel directly after a bleaching session.

Finishing

  • Contouring and shaping can temporarily (or in some cases permanently) increase the sensitivity of the teeth as a result of removing some enamel, making additional treatment necessary.

  • The resin used for bonding is not as strong as the teeth. When biting and chewing hard foods or other materials, it is possible that this resin can break.

Laser gum and frenulum correction

  • Laser gum corrections are usually low-pain procedures. However, afterwards you may experience temporary light pain that typically resolves itself or that can be successfully treated with conventional pain medication. The necessity of additional dental/medical treatments cannot be entirely ruled out.

  • The use of dental lasers can cause injuries to the mucous membranes, tongue, teeth (or any dental superstructures), and more rarely to bone tissue. In rare cases, these injuries can leave infected tissue behind or cause the tissue to die off, which would necessitate further medical treatment.

  • The complications and risks for gum and frenulum correction with a laser are minimal. Your bestsmile dentist will thoroughly inform and advise you about the treatment.

Extractions

  • The medication used for dental extractions (e.g., injection of local anaesthetic) can cause circulatory reactions (e.g., blood pressure changes, heart palpitations, sweating) or nervous system side effects (e.g., anxiety, cramps, difficulty breathing). These side effects usually dissipate without any action required but can necessitate addition dental/medical treatment.

  • The use of local anaesthetic (conduction or infiltration anaesthesia) and instruments such as lasers can cause injuries to the mucous membranes, tongue, surrounding teeth (or to pre-existing dental superstructures), and more rarely to bone tissue. In rare cases this can leave behind a pocket of infected tissue or lead to tissue death.

  • Since extractions take place in the mouth, the tooth in question can accidentally be fully or partially swallowed or inhaled.

  • Bleeding may take place during and/or after the extraction. This is usually easy to treat, but complications can arise if the patient has a predisposition to blood clotting (blood clotting disorder) or if they have been taking anticoagulants. Please inform your bestsmile dentist about the medications you are taking and about your general physical condition.

  • In rare cases, extractions can cause infections that impair healing and/or cause pain in the area that was treated. In these cases, treatment with antibiotics cannot be ruled out.

  • Allergies or hypersensitivities (e.g., to the anaesthetic or other medications used for the extraction, disinfectant, latex) can cause intolerance reactions. Minor allergic reactions may manifest as temporary swelling, itching, sneezing, rashes, dizziness and/or vomiting, et cetera. Stronger allergic reactions can cause acute circulatory shock that would require hospitalisation/intensive care. In extremely rare cases, severe and sometimes permanent damage can occur (e.g., organ failure, brain damage, paralysis).

  • In rare cases, the tooth may break during the extraction, making it necessary to perform an operation to remove the remaining tooth. In individual cases, non-irritating pieces of the root will be left intact if removing them could damage anatomical structures such as nerves.

  • It may be necessary to open up the maxillary cavity since the roots of the teeth in the upper jaw are often separated from the maxillary cavity only by a thin bone.

  • There is a risk of jaw breakage when removing certain teeth or implants that are unfavourably situated in the lower jaw, which would require further dental/medical treatment.

  • In very rare cases, damage to the nerves in the lower jaw and tongue may occur (mainly when injecting anaesthetic or removing bigger pieces of bone). In these cases, numbness to the tongue and lips or disruption to one's sense of taste may occur, either for a longer period of time or in rare cases permanently. This would require further dental/medical treatment, such as a nerve suture.

Local anaesthetic for ceramic dental restorations and extractions

  • The needle or cannula tip can injure mucous membranes, the tongue and in rare cases bone tissue. Injuries of this kind are usually harmless and either heal on their own or can be treated easily. In rare cases, however, infection or death of the injured tissue may occur.

  • The needle or cannula tip can injure blood vessels, causing bleeding and haematoma (internal bleeding in the tissue). Usually injuries of this kind do not require any treatment and heal on their own. Haematoma and more severe bleeding that requires treatment primarily occur in patients who have blood clotting disorders or who take anticoagulants. Please inform your bestsmile dentist about the medications you are taking.

  • Injecting local anaesthesia can, in very rare cases, cause nerve damage, for instance in the lower jaw or tongue. In these cases, numbness to the tongue and lips or disruption to one's sense of taste may occur, either for a longer period of time or in rare cases even permanently.

  • Infections may occur at the injection site. Infections of this kind usually resolve on their own or can be easily treated with antibiotics. In cases of infection or haematoma, patients often experience difficulty opening their mouth, but this usually dissipates within a few days. In rare cases, this difficulty persists and sometimes requires additional dental/medical treatment.

  • As is the case with every kind of injection, the possibility of bacteria entering the bloodstream and causing sepsis or organ inflammation (e.g., to the inner cardiac tissue) cannot be ruled out. Complications of this kind almost never happen for dental procedures but cannot be ruled out entirely.

  • The injection of local anaesthetic can lead to circulatory reactions (e.g., blood pressure changes, heart palpitations, sweating), including short-term circulatory failure with temporary loss of consciousness.

  • Allergies or hypersensitivities (e.g., to anaesthetic or other medications, disinfectant, latex) can lead to intolerance reactions. Minor allergic reactions may manifest as temporary swelling, itching, sneezing, rashes, dizziness and vomiting, et cetera. Stronger allergic reactions can cause acute circulatory shock that would require hospitalisation. In extremely rare cases, severe and sometimes permanent damage can occur (e.g., organ failure, brain damage, paralysis).

  • In very rare cases, the anaesthetic can accidentally enter the bloodstream and cause cramps, loss of consciousness and life-threatening disruption to the heart, circulatory system and lungs. Should this situation occur, emergency medical care would be required.

Important information about local anaesthetic

  • Any instructions from your bestsmile dentist must be precisely and diligently followed.

  • Because of the residual effects of the anaesthetic, your reaction time and ability to drive can be impaired for a period of time, even if you don't notice it yourself.

  • As long as the local anaesthetic is active, patients may bite their cheeks or tongue while chewing. This is why you should not eat or consume hot beverages until the anaesthetic has completely worn off.

  • Please notify your bestsmile dentist immediately if you experience severe pain, intense swelling, fever or persistent bleeding following your procedure.

Wire retainer

  • Wire retainers can sometimes break. With a broken retainer, patients run the risk of injuring their oral cavity or swallowing or inhaling broken parts. Please get in touch with your bestsmile practice or dentist if this is the case.

  • In rare cases, patients may experience sensitivity to the materials used in the retainer, necessitating its removal.

  • Whether it is possible or not to apply the fixed wire retainer strongly depends on individual factors (such as swallowing patterns, tooth position, available space and material compatibility) and is not always possible, especially in the upper jaw. Even with a fixed wire retainer, an additional Retainer Aligner may be necessary, depending on the impact of the above-mentioned factors.

Relax Retainer

  • The Relax Retainer can be damaged or break due to nocturnal grinding. In rare cases, patients may experience sensitivity to the materials used in the Retainer, making it necessary to stop using it.

  • In rare cases, wearing the Relax Retainer can lead to problems in the jaw joint that cause and/or worsen joint pain, headaches, ear problems, tinnitus or other symptoms. Inform your bestsmile dentist immediately if any symptoms of this kind arise.

Other general risks of dental treatments

  • Swallowing and inhalation (aspiration) of medical devices may occur. In case of aspiration accompanied by symptoms such as gagging, difficult breathing, or in case of swallowing sharp, pointed and long objects whose diameter exceeds 2.5 cm, immediately go to the nearest medical emergency unit.