Ronak Patel, D.D.S.

355 E. Westchester Pkwy, Suite 200 Grand Prairie, TX 75052


Root Canal Therapy Information and Consent

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Root canal therapy is a process by which diseased tissue within the tooth is removed by cleansing and shaping with instruments and irrigation with chemical agents. The canals are then dried and filled with an inert material called gutta-percha and a sealer. This process allows for the involved tooth/teeth to re-establish a normal relationship with the surrounding tissues following a healing period of twelve to twenty-four months.

A 95% success rate is typical with treatment. However a guarantee of treatment is neither stated nor implied.

Procedural complications can occur which may result in the need for additional treatment, to possibly include surgical treatment or extraction. These include, but are not limited to: separated instrument(s), perforation, fracture of the involved tooth or individual root, and/or blocked canals.You understand that the administration of local anesthetic may cause an untoward reaction or side effects, which may include, but are not limited to, bruising; hematoma; cardiac stimulation; allergies; allergic reactions; muscle soreness; and temporary or rarely, permanent numbness. You also understand that occasionally needles break and may require surgical retrieval.

Risks to treatment include pain, swelling, and possibly infection. In rare instances allergic reactions to root-canal filling materials have been documented.

Alternatives to endodontic treatment include extraction or doing nothing. Risks associated with failure to proceed with either endodontic treatment or extraction are extensive and include the potential of losing large amounts of bone, multiple tooth loss, hospitalization for the treatment of extensive infection, and possible death.

Damage to existing restorations is possible. Additionally, alteration of tooth structure or existing may be required to provide adequate root canal therapy.

If you have ever taken Zometa, Aredia, Fosamax, Boniva, Actonel, Skelid, Bonefos, Ostac, Didronel either orally or by I.V. notify us immediately. These drugs are used to treat osteoporosis, osteopenia, bone cancer, and post-menopausal bone loss and can cause poor bone healing resulting in osteonecrosis, (death of the bone) which is a very serious and often untreatable complication.

Proper post-treatment restoration is required.

Recall examination is highly recommended and requires radiographic evaluation.

I have discussed Root Canal Therapy with Dr. Patel , and have had all my questions answered.

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