Consent for Root Canal Treatment

The nature and purpose of root canal treatment, which includes the possibility of infection that becomes systemic in nature, and possible alternative methods of treatment including extractions have been explained to me and I understand them. I understand that during treatment I may have periods of discomfort and swelling and all possible will be done to minimize this. Moreover, many factors contribute to the success of root canal treatment and cannot be determined in advance. Therefore, in some few cases treatment may have to be discontinued and be referred to a specialist, or may fail following treatment. Some of the factors which may lead to an untoward result are: my resistance to infection following treatment, fracture of the tooth prior to completion of the root canal and /or before the definitive restorative procedure, separation of an instrument, the perforation of the root canal, and the location and shape of the canals.
I have been informed that should the treatment have to be discontinued before completion, or if it fails following treatment, other procedures may be necessary to save the tooth, including but not limited to: retreatment or even apicoectomy (root end snip) in the future. If endodontic surgery is necessary, the possible sequelae of surgical treatment has been explained. In case of an acute emergency and in the event you cannot reach this office proceed to the nearest emergency.
I further understand that during and following the treatemnt, I must follow all home care instructions, and I am to contact the doctors' office if I have any additional questions, or I experience any unexpected reactions.
I acknowledge that no guarantees or assurances have been given by anyone as to the results that may be obtained although root canal therapy typically follows over 90% success.
I have discussed all of the above with the doctor, and have had all my questions answered.