Treatment Forms
Dental & Periodontal Clearance
Before beginning orthodontic treatment, it's essential to ensure your teeth and gums are healthy. This clearance form helps coordinate care between your general dentist, periodontist, and our orthodontic team.
Why Dental Clearance Matters
Healthy teeth and gums are the foundation of successful orthodontic treatment
Cavity-Free Start
Ensures all cavities are treated before brackets or aligners are placed, preventing complications during treatment.
Healthy Gums
Confirms your gums are healthy and free from periodontal disease, which is crucial for tooth movement.
Coordinated Care
Facilitates communication between your dental team to ensure comprehensive oral health throughout treatment.
Download the Form
Please have your dentist or periodontist complete this form and return it to our office before your orthodontic treatment begins.
How to Submit Your Clearance Form
Download & Print
Download the PDF form and print it out, or request a copy from our office during your consultation.
Visit Your Dentist
Take the form to your general dentist or periodontist for completion. They'll verify your oral health status.
Return to Us
Send the completed form back to our office via email, fax, or bring it to your next appointment.
Submission Methods
Email: hello@seaportsmiles.com
Fax: (617) 741-5650
In Person: 268 Summer Street, 2nd Floor, Boston, MA 02210
Questions About the Form?
Our team is happy to help explain the clearance process or assist with any questions you may have.