Most frequently seen complication in our office is nausea from taking narcotic pain medication. So do not take pain med on empty stomach. Do not mix pain med with other meds. Keep gauze pack in so you do not swallow blood.

You have a right to be informed about your dental problem, your options and the surgery planned so that you can decide whether to undergo the procedure after knowing the risks involved.

In regard to wisdom teeth: there are some differences of opinion as to whether wisdom teeth should be removed. If wisdom teeth (third molars are in function and can be kept clean then they should not be removed. Wisdom teeth do not cause crowding of the front teeth. Some wisdom teeth if left in can form cysts around them and in rare instances, tumors. Impacted wisdom teeth if left in can cause decay or damage adjacent teeth. There are risks to having wisdom teeth removed, as you will see. When you get older the wisdom teeth become harder to remove and the risks of complications increase.

Some insurance policies do not cover or recommend the extraction of asymptomatic wisdom teeth. Asymptomatic means there is no obvious problem. You have a right to be informed about your dental problem, your options and the surgery planned so that you can decide whether to undergo the procedure after knowing the risks involved.

There are options to having a tooth or several teeth removed. If you elect to do nothing, this has its own consequences such as infection and pain and in rare instances death. In some cases root canal therapy is an option.

Anesthesia Risks

Local anesthetic risks include heart palpitations. The feeling of anxiety and sweating. There can be pain swelling, bruising, infection, nerve damage, numbness, heart attack, stroke, brain damage, and/or death.

Intravenous sedation. The IV surgery requires that you have not eaten or drank for six hours prior to surgery. Risks include nausea, sore arm or phlebitis at the IV entry point. Rare complications include death, idiosyncratic drug reactions, pneumonia, heart attack, stroke, brain damage, and/or death.

For tooth extractions

Dry socket is a significant pain in the jaw and ear due to loss of the blood clot. It most commonly occurs after the removal of lower wisdom teeth but is possible with any extraction.

There can be muscle trismus, that is a limited opening of the jaws caused by inflammation and or swelling in the muscles. This is most common with impacted wisdom teeth and lower jaw teeth. There can be TMJ problems may not function well and may rarely need treatment ranging from alternating hot and cold packs and rest to surgery.

Infection is possible with any surgical procedure and may require further surgery or medications.

Bleeding may occur after surgery and is most often controlled by following the written and verbal instructions of the doctor and staff. Drug reactions are possible from any medication given and could result in nausea, rash, anaphylactic shock. and /or death.

Drug reactions are possible from any medication given and could result in nausea, rash, anaphylactic shock and/or death. Damage to other fillings and/or teeth are possible because of the close proximity of teeth to one another. Teeth other than the one being extracted and/or fillings may be damaged when a tooth is extracted.

Sharp ridges or bone splinters may occasionally cone out through the gum. This may require another surgery to smooth or remove the bone splinter. This happens most often when several teeth are removed at one time but can happen with difficult extractions and any extraction. Incomplete removal of tooth fragments. Sometimes the doctor may decide to leave a tooth fragment or root to avoid doing damage to adjacent structures such as nerves and sinuses. Sometimes the doctor will not see or notice a small tooth fragment was left. This happens most often when a tooth has to be drilled out.

Lower Teeth Numbness.

Due to proximity of the roots to nerves especially wisdom teeth bruising or damaging, tearing or cutting of the nerves is possible. This can cause numbness, which may last for days, weeks, or rarely permanently. The lip, chin, and/or tongue could feel numbness, tingling, or burning sensations.

Upper Teeth Sinus Involvement

Due to the location of the roots, especially the upper back teeth and the sinus an opening from the sinus to the mouth may develop or a root may be displaced into the sinus when a tooth is extracted. A possible sinus infection and/or permanent opening from the mouth to the sinus could develop which might require medication and/or surgery later to correct.

EXTRACTION OF THE "WRONG" TOOTH

In rare instances the dentist can pull the wrong tooth. Why would this be? It could be because there are several bad teeth in the area in question. It could be a miscommunication between the dentist and the patient It could be that the patient is uncertain of which tooth is a problem. It could just be the wrong tooth. It is important for the patient to be clear to the dentist which teeth are wanted out. In most cases the wrong tooth pulled is not healthy and needed to come out.

So please write in your own words what you think you are going to have done:

__________________________________________________________________

Other possible complications:

__________________________________________________________________

__________________________________________________________________

Patient name____________________________

I hereby authorize Dr. Starkey or one of his associates to perform the following procedures:

__________________________________________________________________

__________________________________________________________________

And to administer the necessary anesthesia. I understand the doctor may discover conditions that require additional procedures other than those previously stated. I authorize him to perform any procedures that are advisable in his professional judgment.

I have read and discussed the preceding risks that may occur in connection with this procedure. I have been given sufficient information and all my questions have been answered. I give my consent to Dr. Starkey and his staff for this surgery.

I have been given this form and the risks reviewed with me by Dr. Starkey at least the day before the surgical appointment. So I have had time to consider my options.

I have been given this form and the risks reviewed with me by Dr. Starkey at least the day before the surgical appointment. So I have had time to consider my options.

Patient/legally responsible person:_______________________________________

Date_______________________ Witness_________________________________