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  • Non-surgical Periodontal Scaling And Root Planing Consent Form

Get Non-surgical Periodontal Scaling And Root Planing Consent Form

6268 Poplar Avenue ? Memphis, TN 38119 ? phone 901- ?761- ?3770 ? toll free 800- ?824- ?1628 fax 901- ?761- ?3775 www.PerioMem.com Info PerioMem.com Roger D. Craddock, D.D.S. Partners Emeritus: Mitchel.

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How to fill out the Non-Surgical Periodontal Scaling And Root Planing Consent Form online

Filling out the Non-Surgical Periodontal Scaling And Root Planing Consent Form online is an essential step in authorizing your dental procedure. This guide provides clear, user-friendly instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the consent form online.

  1. Press the ‘Get Form’ button to access the consent form and open it in your editing tool.
  2. Start by entering the name of the patient in the designated field. This identifies who is giving consent for the treatment.
  3. Review the section that explains the purpose of the treatment. It is important to understand that this procedure aims to treat diseased gum tissues, teeth, implants, and jawbones.
  4. Read and acknowledge the alternatives to the proposed treatment. It’s crucial to be informed about any other methods that may be available to you.
  5. Carefully go through the listed post-operative risks associated with the treatment, such as pain or sensitivity; make sure to understand these before proceeding.
  6. Acknowledge your understanding of the potential consequences of not receiving treatment, emphasizing that your periodontal condition may worsen without action.
  7. Confirm that no guarantees regarding the treatment's success have been made to you, fostering realistic expectations.
  8. Indicate your commitment to post-treatment care, including daily home care and regular maintenance visits.
  9. Sign and date the form in the sections for the patient, dentist, and witness where indicated.
  10. Finally, save your changes and choose whether to download, print, or share your completed consent form.

Complete your documents online today to ensure a smooth process for your treatment.

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Scaling and Root Planing Costs A regular dental prophylaxis (professional teeth cleaning) can average between $50 $100+ depending on a number of factors, (check all fees in general these may be low) while the cost of periodontal scaling and root planing averages between $140 and $300 (per quadrant).

* Many carriers have a "minimum-tooth" eligibility for full-quadrant benefits to apply. Most require at least five involved teeth per quadrant. (If fewer than five teeth need root-planing, the quadrant can be reported as a fraction. For example; 4/5 of a quadrant for four teeth, 3/5 of a quadrant for three teeth, etc.)

If the pockets between your gums and teeth are too deep, however, scaling and root planing may be needed. A July 2015 study in the Journal of the American Dental Association finds that scaling and root planing is beneficial to patients with chronic periodontitis (gum disease that has advanced past gingivitis).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232