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Silver diamine fluoride consent form 2026

The document provides informed consent information for the use of silver diamine fluoride (SDF) as a treatment for cavities and tooth sensitivity. It outlines the procedure for application, benefits such as stopping tooth decay and relieving sensitivity, and potential risks including permanent staining of affected areas and possible discoloration of fillings. It also specifies contraindications for SDF use, alternative treatments, and emphasizes that there is no guarantee of success in halting decay.

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Click ‘Get Form’ to open the silver diamine fluoride consent form in the editor.
Begin by reading through the entire document to understand the procedure, benefits, and risks associated with silver diamine fluoride treatment.
In the section titled 'I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THIS DOCUMENT,' ensure you acknowledge your understanding by signing in the designated area for either the patient or parent.
Next, enter the date next to your signature to confirm when you completed this consent.
If applicable, have a witness sign and date their section to validate the consent process.

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