J Oral Maxillofac Surg 67:1021-1025, 2009 Value of Informed Consent in Surgical Orthodontics Sander Brons, DDS,* Alfred G. Becking, DMD, MD, PhD,† and D. Bram Tuinzing, DMD, PhD‡ Purpose: Informed consent forms an important part of treatment, especially in the case of elective treatment. The aim of this survey was to establish how much patients can recall of the information given during an informed consent interview before orthognathic surgery. During the consultation, attention was given to all aspects of the treatment. However, because of “insurance-related factors,” the need for treatment because of functional reasons was stressed over esthetics. The recall of information given during an informed consent interview before orthognathic surgery was measured using a questionnaire. Materials and Methods: Patients with a mandibular deficiency with a low mandibular plane angle were questioned after an informed consent interview regarding surgical orthodontic treatment. Results: Esthetics were more frequently and functional problems were less frequently recalled as the reason for operation than was expected. The risk of a change in the sensation of the lower lip by surgery was frequently recalled as a reason to refrain from the operation. The overall recall rate of the possible risks and complications of orthodontic surgery was 40%. Conclusions: No reports were found of comparable research on the preoperative recall after consul- tation before surgical orthodontic surgery. The aspects of communication that can improve recall must be clarified. A recall rate of 100% seems a utopia, although an arbitrary line is needed to determine the quality of an informed consent interview. © 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1021-1025, 2009 Currently, informed consent forms an important part of medical treatment. Adequately informing a patient confirms the patient– doctor relationship is based on trust. Another important function of informed con- sent is the fulfillment of the legal obligation of the physician to inform the patient to the best of his knowledge. However, to be certain of having fulfilled the legal obligation, it is necessary to qualify the process of informed consent. For patients to consent to a procedure, they should be informed by the medical staff. This can be done verbally by the physician or nurse practitioner and by written or visual information (pictures or video). By Dutch law (Wet Geneeskundige Behandel Overeen- komst [WGBO]) physicians are obligated to provide patients with a description of the diagnosis; the rec- ommended or proposed treatment; technical details of the procedure; probable risks, goals, and benefits; and alternative modes of therapy. Recently, an informed consent model for orthog- nathic surgery was proposed by Gasparini et al. 1 In this model, it is recommended to divide the informed consent form into 2 parts. The first part concerns the diagnostic procedures and the therapeutic and surgi- cal time frames, and the second part, the possible problems and difficulties of the procedure. According to Humphris et al, 2 the informed con- sent interview should be supported by an information leaflet. In their study on third molar removal, it ap- peared that the provision of an information leaflet as an adjunct to the verbal information resulted in an increase of patient knowledge. In contrast, Rittersma 3 stresses the importance of personal surgeon–patient communication as superior to written information. The correction of maxillofacial deformities by sur- gical orthodontic treatment is an elective procedure. Received from the Department of Oral and Maxillofacial Surgery/ Pathology, Academic Centre for Dentistry Amsterdam and VU Uni- versity Medical Center, Amsterdam, The Netherlands. *Postgraduate Student. †Oral and Maxillofacial Surgeon. ‡Professor. Address correspondence and reprint requests to Dr Tuinzing: Department of Oral and Maxillofacial Surgery/Pathology, Academic Centre for Dentistry Amsterdam and VU University Medical Center, PO Box 7057, Amsterdam 1007 MB The Netherlands; e-mail: bramtuinzing@gmail.com © 2009 American Association of Oral and Maxillofacial Surgeons 0278-2391/09/6705-0014$36.00/0 doi:10.1016/j.joms.2008.12.038 1021