Informed Consent Extraction

1. Purpose of the Procedure

The goal of a dental extraction is the surgical removal of a tooth. This procedure is recommended when a tooth is non-restorable, creates a risk of infection, or interferes with the overall health of the oral cavity, or even preprosthetically. Common reasons include:

• Severe Decay: Damage too extensive for a crown or root canal.

• Periodontal Disease: Loss of supporting bone structure.

• Impaction: Teeth (often wisdom teeth) that cannot erupt properly.

• Orthodontic Necessity: Creating space for tooth alignment.

2. Clinical Risks and Complications

While tooth extraction is a routine procedure, it is a surgical intervention. By reviewing this, you acknowledge that all surgeries involve inherent risks, including but not limited to:

• Alveolar Osteitis (Dry Socket): A condition where the blood clot dislodges prematurely, exposing the bone and causing significant pain. This is more common in smokers and users of oral contraceptives.

• Infection: Post-operative infection may require antibiotics or further surgical drainage.

• Nerve Injury: Proximity of tooth roots to the mandibular or maxillary nerves may result in temporary or, in rare cases, permanent numbness (paresthesia), tingling, or altered sensation in the lip, tongue, chin, or gums.

• Sinus Involvement: For upper teeth, the roots may be near the maxillary sinus. Extraction may result in a "sinus communication" (an opening between the mouth and sinus), which may require additional surgery to close.

• Damage to Adjacent Structures: Including chips or fractures to neighboring teeth, fillings, or crowns.

• Fractured Roots: Small pieces of the root may break off during extraction. The surgeon may decide to leave these in place if removal poses a higher risk to nerves or bone.

• Jaw Fracture: Though extremely rare, the pressure required for extraction can cause a fracture in a weakened jawbone.

3. Post-Operative Expectations

Following the procedure, patients should expect a standard healing period characterized by:

1. Hemorrhage: Minor oozing is normal for 24 hours.

2. Edema (Swelling): Typically peaks 48–72 hours post-surgery.

3. Trismus: Stiffness of the jaw muscles, making it difficult to open the mouth wide.

4. Ecchymosis: Bruising of the skin or soft tissues near the site.

4. Alternatives to Extraction

Before proceeding, the patient should be aware of alternatives, which may include:

• Root Canal Therapy: Attempting to save the internal structure of the tooth.

• Periodontal Treatment: Treating the gum and bone to stabilize the tooth.

• No Treatment: Choosing to leave the tooth in place. Warning: Foregoing treatment may lead to systemic infection, abscess, severe pain, and the spread of bone loss to adjacent healthy teeth.

5. Patient Responsibilities & Disclosure

To minimize risks, the patient must disclose a full medical history, including:

• Medications: Specifically Blood Thinners (Anticoagulants) or Bisphosphonates (osteoporosis medication), which significantly increase the risk of bone necrosis.

• Systemic Conditions: Heart murmurs, diabetes, or autoimmune disorders.

• Post-Op Compliance: Failure to follow the prescribed "Post-Operative Care Instructions" (e.g., avoiding straws, smoking, or vigorous rinsing) directly increases the likelihood of complications.