Nature of the Procedure
– Fluoride Application: The application of topical fluoride to strengthen teeth and help prevent cavities.
– Dental Sealant: Placement of a protective coating on the chewing surfaces of back teeth to prevent
decay.
Benefits
– Fluoride helps make teeth more resistant to decay.
– Sealants create a barrier that protects grooves and pits from bacteria and food particles.
– Both procedures are painless, quick, and safe.
Risks and Complications
– Temporary taste changes.
– Rare chance of mild allergic reaction.
– Sealants may wear down or chip and need replacement over time.
– Neither procedure guarantees complete protection from cavities—good oral hygiene and regular
dental visits are still necessary.
Alternatives
– No preventive treatment (higher risk of developing cavities).
– Regular oral hygiene and professional cleanings only.
Acknowledgment and Consent
I have read and understood the information about fluoride application and/or dental sealant treatment.
I understand the benefits, risks, and alternatives.
I have had the opportunity to ask questions, and all have been answered to my satisfaction.
I voluntarily consent to the selected procedure(s).
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