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Potential Risks and Complications: 1. In preparing the teeth for the reception of cosmetic veneers, either made of porcelain or composite resin, it may be necessary to reduce or roughen the surface of the tooth to which the veneer(s) may be bonded. This preparation will be done as conservatively as possible, but once this is done, the patient is committed to veneers or crowns for the duration of life. If the veneer covering breaks or comes off, the uncovered tooth may become susceptible to decay if the veneer is not replaced in a timely manner. *

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2. Sensitivity of teeth: Through the process of modifying teeth to accept veneers, there is the possibility of the development of tooth sensitivity which may last for days or months following tooth preparation. In most cases, this sensitivity will alleviate over time but in rare instances is permanent. *

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3. Chipping, breaking or loosening of the veneer may occur any time following placement. Many factors may contribute to this happening such as chewing of excessively hard materials; changes in occlusal (biting) forces; traumatic blows to the mouth; failure of the bond between the veneer and tooth; and other such conditions over which the dentist has no control.

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4. Alteration in speech: Since the veneers may be wider and/or longer than the natural teeth they are covering, a difference in speech may be evident. Many times the patient will adapt to the change and speech returns to normal very shortly after placement. The veneers may need to be adjusted in order to alleviate problems with speech. *

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5. Sensitive or allergic reactions to anaesthetics or materials used in the procedure. Different anaesthesia and adhesive materials are used for composite bonding and veneer procedures, which patients may have an allergic reaction to if not otherwise known about before. Please ensure you have provided the dental team with all known allergies before the treatment. *

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6. Aesthetics/Appearance: Every attempt possible will be made to match and coordinate both the form and shade of veneers, which will be placed to be cosmetically pleasing to the patient. However, there are some differences, which may exist between that which is natural and that which is artificial making it impossible to have the shade and/or form perfectly match your natural dentition. Once veneers are bonded to place on the teeth, should the patient desire any changes later a fee may be assessed to cover any extensive adjustments or remakes. *

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7. Longevity: It is impossible to place any specific time criteria on the length of time that veneers should last. Once the tooth structure is prepared for veneer placement, the patient is committed to veneers for life. Should the veneers become damaged, leaky, or stained, they will need to be replaced.

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8. Veneers are susceptible to staining just like natural teeth: Composite resin veneers tend to stain more readily than porcelain. The veneers may need to be replaced if excessive staining, marginal leakage, or chipping occurs. Every attempt to avoid stain-inducing foods and drinks should be avoided.

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9. Post treatment protection: An acrylic lab fabricated night guard may be indicated to help protect your veneers from damage due to night time clenching and grinding. I certify that I have read the above and fully understand this consent for treatment. I understand that a perfect result cannot be guaranteed. I am aware of the fee(s) associated with this treatment and am responsible for any and all payments not covered by my insurance.

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Informed consent *

I have been given the opportunity to ask any questions regarding the nature and purpose of crown and/or bridge treatment and have received answers to my satisfaction. I voluntarily assume any and all possibly risks including those as listed above and including risk of substantial harm, if any, which may be associated with any phase of this treatment in hopes of obtaining the desired results, which may or may not be achieved. No guarantees or promises have been made to me concerning the results. The fee(s) for service have been explained to me and are satisfactory. By signing this document, I am freely giving my consent to allow and authorize my Doctor to render any treatment necessary and/or advisable to my dental conditions including the prescribing and administering of any medications and/or anaesthetics deemed necessary to my treatment.

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