Dental Anesthesia Consent Form

Dental Anesthesia

Anesthetics are frequently used in most dental procedures; commonly used for most restorative and surgical procedures. Different anesthetics may be used based on your needs, length of needed anesthesia, or medical history issues. All anesthetics used in this office will be of "local delivery" only and will involve injections for infiltration, or nerve blocks. There are risks associated with injections of anesthetics into the mouth that range from allergic reactions, to traumatic injuries to nerves and blood vessels. Great effort is made to minimize these risks. you must advise us if you encounter, or have encountered, any unusual reactions to any anesthetic, or injection.

I understand that I will be given a local anesthetic injection and that in rare situations patients have had an allergic reaction to the anesthetic, an adverse medication reaction to the anesthetic, or temporary or permanent injury to nerves and or blood vessels from the injection. I understand that the injection area(s) may be uncomfortable following treatment and that my jaw may be stiff and sore from the anesthetic injection.