Retention Consent Form

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We are so happy that your orthodontic treatment is complete, we have loved having you as a patient!

In order for your smile to remain the same and your teeth straight it is imperative that you wear your retainers as instructed. Without retention appliances your teeth could move and in some instances this is significant movement and very quickly. You will be issued with clear aligners which must be worn every night consistently to mitigate the chance of any relapse. Teeth cannot move when retainers are worn per our instructions.

You retainers will be checked regularly over the next 12 months either virtually or in clinic. Should you fail to complete the required retainer checks and / or should retainers not be worn as instructed and teeth move we will need to see you for a consultation and provide a quote to retreat you.

Should a lingual wire be prescribed to you for clinical necessity there is a 3 month warranty for these wires. Repair or replacement will incur further fees after this time, beyond 3 months from placement.

The current fees for replacement or repair are:

*Fees are subject to change owing to annual cost increases

Retainer replacement per arch - $210

Vivera Retainers (set of 3) - $680

Lingual wire replacement - $625

Lingual wire repair - $150

I have read and understood the importance of retention and understand the consequences of not following the retention instructions. I confirm that I am happy with the current position of my teeth.

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