Laser Assisted Periodontal Therapy Consent Form

Seibert d m d ltd in champaign and charleston il.

Laser assisted periodontal therapy consent form.

Please submit the form prior to arrival. I realize that this disease may be painless. It is photo thermal produces heat. Monique fitch performing laser therapy on me.

Periodontal diseases are infections in the structures around the teeth. Laser energy is not ionizing radiation i e. In laser assisted periodontal therapy or lapt dr. Huber has informed me that i have periodontal disease.

These glasses are specific to the type of laser. Please bring your own mask or face covering. Benefits of laser therapy. Informed consent and authorization for periodontal treatment utilizing the laser assisted new attachment procedure lanap 1.

Use of a laser for dental treatment hard and or soft tissue and root canal is a very safe and predictable form of treatment. Informed consent periodontal treatment patient name procedure i understand that i have periodontal gum and bone disease. Laser gum treatment cost in us uk and worldwide. You will be asked to use our hand sanitizer upon entering and leaving the office.

Safety glasses are worn to protect the eyes from any unforeseen effects. I have read and understand this consent form i agree to its terms and authorize treatment. I do hereby waive release absolve. Gene greenlees md or wendy greenlees rn np has explained the nature and purpose of the laser treatment including any risks and possible complications and has discussed the contents of this form with me.

Due to the covid 19 pandemic we have instituted an additional dental treatment consent form. The laser cauterizes blood vessels and nerve endings to reduce bleeding and pain. Greenberg uses a special soft and hard tissue laser the waterlase laser this will remove diseased tissue leaving healthy tissue intact and bacteria free. This disease process has been explained to me and i understand it is caused by bacterial toxins.

I consent to dr. Laser therapy is designed to eliminate or substantially reduce periodontally diseased gums and or pockets to help control or prevent future periodontal disease progression. Before to deep dive into all costs of treating gum disease with laser you should remember that the laser therapy is a complementary method to cure gingival problems. Download our online periodontal treatment consent form and bring to your visit to steven w.