Download Dental Consent Form

Animal General
725 River Rd.
Edgewater, NJ 07020
Dental Consent Form
Please Read
During the physical examination, it is often not possible to completely evaluate the
degree of dental disease. Only when your pet is under anesthesia can a thorough dental
exam be done. Because of this, dental problems such as loose, diseased or fractured teeth
may be later discovered while under anesthesia. We try to make the preliminary estimate
accurate, but this is not always possible in the examination room. In order to accurately
access your pet’s dental needs some additional procedures may be necessary:
1. Dental Extractions for hopeless, painful and fractured teeth
Agree_____
Disagree_____
2. Gingival/Gum Flap Surgery to close gaps left by extractions
Agree_____
Disagree_____
3. Dental x-rays if there is periodontal disease or suspected root exposure
Agree_____
Disagree_____
4. Oravet Gel Application is a sealant that creates an invisible barrier that prevents plaque and tarter forming bacteria
from attaching to the teeth. This would be good if you are able to work on your pet’s mouth and able to keep up
once a week. This is an OPTIONAL treatment
Agree_____
Disagree_____
Print: __________________________________________________________________
Signature:
____________________________________________________________
Date: __________________________________________________________________