Dental Materials Fact Sheet Acknowledgment (California)

California Business and Professions Code sections 1648.10 through 1648.20 require the Dental Board of California to publish a fact sheet about the materials used to restore teeth, and require dentists to provide that fact sheet to patients. The Board's fact sheet is titled “The Facts About Fillings.” Section 1648.15 requires that the patient sign an acknowledgment of receipt and that a copy of the acknowledgment be placed in the patient's dental record.

The fact sheet is written and published by the Dental Board, not by this practice. This practice may not alter it. You can read or download the current version at dbc.ca.gov under Forms and Publications; it is published in English, Spanish, and Chinese. If you would prefer a printed copy, ask any member of the team and one will be given to you.

• The main materials used to fill and restore teeth, including dental amalgam, composite resin, glass ionomer, resin ionomer, porcelain, and gold alloys.
• The advantages and disadvantages the Board attributes to each material, including durability, appearance, cost, and the number of visits usually required.
• The Board's discussion of dental amalgam and mercury, and the Proposition 65 listing that applies to it.

The statute defines dental restorative materials as materials used to restore natural tooth structure, and section 1648.20 states that the definition does not include synthetic replacements for extracted teeth. Implants themselves therefore sit outside that definition. The fact sheet is still relevant to you because implant treatment frequently involves restorative work — crowns, bridges, and prosthesis materials — and because you may have existing restorations that will be discussed as part of your plan.

This practice provides the fact sheet to every new patient rather than trying to predict which patients the statute reaches. Signing this acknowledgment confirms only that you received the fact sheet. It is not consent to any treatment.