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A-Dental Center

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For Our Patients

I have received a copy of the “DENTAL MATERIALS FACT SHEET” dated October 2001 by the Dental Board of California. We are required by law to get signed acknowledgement that all patients and /or guardian have received this information.
In order to simplify the practical application of the information in the “DENTAL MATERIALS FACT SHEET” the following is a summary of the materials we usually use in our office:
I understand that the treatment of my dentition involving the placement of composite resin fillings, which may be more aesthetic in appearance than some of the conventional materials that have been traditionally used, such as silver amalgam or gold, may entail certain risks.
These are more expensive than fillings and used where the tooth is not strong enough to hold a filling. They have an excellent appearance (esthetics) and are durable.
3. GOLD ALLOYS These are expensive and durable restorations. They have poor appearance (esthetics) but low incidence of allergic reaction.
It is our policy in any clinical applications to recommend the material that in our professional opinion is the best combination of cost, durability, and appearance.
Please feel free to discuss any of this information with us.

(Your digital signature (full name) is as legally binding as a physical signature.)