How to Do Proper Informed Consents in Braces, Invisalign, and Aligners to Avoid a Lawsuit

I. Introduction

  • Dr. Amanda from StraightSmile Solutions continues her series on avoiding lawsuits and board complaints.
  • Informed consents aren’t just paperwork; they’re your first line of defense.
  • And no, you can’t delegate the responsibility.

II. The Golden Rule: It’s YOUR Job

  • Doesn’t matter who the office manager is. Doesn’t matter who the treatment coordinator is.
  • You are the dentist. You are legally responsible.
  • Never trust a verbal “Yeah, it’s signed.” Walk your boots over and see it yourself.
  • Check the name. Check the age. Check the signature. Check the lines.

III. The Verbal Check-In

  • After they sign, sit down with them. “Any questions on any of these lines?”
  • Most will say no. That’s fine. But you asked.
  • Then sign below it yourself, date, print your name, even if there’s no line.
  • This documents that YOU verified consent before touching the patient.

IV. Minors and Authorization

  • Under 18? Can’t sign. Period.
  • Verify who’s signing. “Are you the parent?” Document the relationship.
  • If you’re unsure, stop. Sort it out before proceeding.

V. Highlighting the Risks

  • Every case has risks: root resorption, impactions, perio, decalcification, caries.
  • If a tooth is tipped, overlapping, or has existing recession, call it out.
  • Use a highlighter. Put stars next to high-risk items. “Hey, I want to go over a few things that stood out to me.”
  • This isn’t scaring them. It’s informing them. And it covers you.

VI. The Three-Way Documentation Rule

  • Important risks should appear in THREE places:
    1. The informed consent
    2. The treatment plan
    3. A supplemental consent if needed
  • Patients should initial each line item, not just sign the bottom.
  • If your consent form doesn’t have line-item initials, consider updating it.

VII. Risk-Benefit-Alternatives

  • PARQ? Risk, benefits, alternatives, it’s part of informed consent.
  • They need to know what could go wrong, what could go right, and what other options exist.
  • Document that conversation.

VIII. Language and Translation

  • If English isn’t their first language, ask: “Would you like this translated?”
  • Don’t rely on Google Translate for legal documents.
  • Have a translator if needed. Ask your attorney about requirements in your state.

IX. The Bottom Line

  • Ortho is a marathon, not a sprint.
  • Don’t rush starts just to hit production numbers.
  • One missing signature, one missed conversation, one “I didn’t know” from a patient, and it could cost you everything.
  • Run your cases by an orthodontist who knows what they’re looking for. Engines won’t look out for you.