TempDenture

A patient consent form for a temporary removable partial denture, often called a flipper, in acrylic or flexible material. It explains that a flipper temporarily replaces missing teeth, mainly for appearance, and is not a permanent prosthesis. It notes that the flipper is often made before extractions, may not fit exactly at first, and may need adjustment visits as the tissue heals. The patient acknowledges that leaving it out for long periods lets natural teeth shift.

Present it before the flipper is made, usually at the visit where extractions and the replacement plan are discussed. The doctor or assistant reviews it with the patient, answers questions, and collects the signature for the chart.