Temporary Appliances Informed Consent Form

The AADSM Informed Consent for Temporary Oral Appliance Use form is intended to assist members in informing their patients about the risks and benefits of using a temporary oral appliance.

While written informed consent is evidence that a treating dentist fully informed a patient of all pertinent medical information regarding a temporary oral appliance, an interview or discussion by the treating dentist with the patient is also required.  

Important Disclaimer: The following Model AADSM Temporary Oral Appliance Informed Consent (“Consent”) was developed by AADSM members for informational and educational purposes only and is intended solely to serve as a resource to AADSM members. AADSM is not undertaking to render specific professional or legal advice. AADSM does not “approve”, “endorse” or otherwise support the use of the Consent or the information included therein.
 
The Consent does not take into account (nor comply with) applicable state, local or other statutes, regulations or laws. Accordingly, the Consent will not (and does not proport to) protect dentists from liability, generally, for malpractice or negligence in the performance of medical/dental services. What constitutes “informed consent” is governed by the statutes and case law of the individual states where the dentist practices.
 
AADSM makes no guarantee, representation, or warranty, express or implied, at law or in equity, and expressly disclaims any and all such guarantees, representations or warranties whatsoever, as to the validity, accuracy or sufficiency of the Consent, and assumes no responsibility or liability in connection therewith.

 
Updated December 19, 2022