Common Concerns

Postoperative discomfort and swelling that may necessitate several days of home recuperation
Restricted mouth opening for several days or weeks
Dry socket
Prolonged bleeding
Postoperative infection requiring additional treatment
Prolonged drowsiness
Nausea and vomiting (usually associated with medications prescribed for pain)

Exceptional Occurrences

Decision to leave a small piece of root in the jaw when removal would require extensive surgery
Damage to adjacent teeth, fillings, and crowns
Injury to the tongue, cheek or other oral tissues to be inadvertently abraded or lacerated (cut). In some cases, sutures or additional treatment may be required.
Stretching of the corners of the mouth with resulting cracking and bruising
Opening into the maxillary nasal sinus or nose requiring additional surgery
Fracture of the jaw
Change in occlusion and temporal-mandibular joint difficulty including bite differences and jaw discomfort
Injury to the nerve underlying the teeth resulting in numbness or tingling of the lip, chin, gums, cheek, teeth, and/or tongue on the operated side. This may persist for several weeks, months, or in remote instances be permanent.

I consent to the administration of local anesthesia (ie. Lidocaine), in connection to the procedure referred to above.

I certify that I have read this consent in its entirety and fully understand its contents, all associated risks, and that a perfect result will not be guaranteed. If unexpected problems arise during the procedure, the doctor has my permission to do what is deemed necessary to correct the condition.

Drugs given at the time of surgery for sedative purposes or control of pain following the surgery may cause drowsiness and a lack of awareness or coordination. I have been advised to have an escort for these reasons. If instructed not to do so, I will not drive or perform hazardous chores until I have recovered from the effects of these medicines.