ObjectiveTo determine the level of patient and/or parent recall of previous consent to orthodontic treatment. DesignPatients and/or parents of children who had been consented for orthodontic treatment were asked to complete a questionnaire on consent at least six months into their treatment. SettingBristol Dental Hospital. Subjects and methodsForty-one consecutive patients and eight of their parents, with a combined age range of 12-59 years, with 61% being female and 39% male. The patients, and where applicable their parents, were identifi ed as having previously signed a consent form at least six months previously. Each was asked to complete a questionnaire on aspects of the consent process. ResultsPatients and parents demonstrated a high level of recall for the consent process concerning appliance type (89.8%), the reasons for treatment (96%), risks (75.5%), length of treatment (83.3%), the opportunity to ask questions (96%), and whether other information was provided (94%). However, further questioning on risks demonstrated poor recall for important factors such as decay (36.8%), root resorption (less than 21%), retention (56.3%) and length of retention (35%). ConclusionsOverall the consent process works well but specifi c areas of concern centre around the risks of orthodontic treatment.

The clinical course of a patient is described in whom hyperphosphatemia occurred on total parenteral nutrition with lipid emulsion providing half of the nonnitrogenous caloric support. Renal insufficiency, hypoparathyroidism, pseudohypoparathyroidism, and severe catabolism are excluded as causes of this hyperphosphatemia. Changes in serum phosphate are attributed to metabolism of phospholipid present in the lipid emulsion, the sole phosphate source in this patient. These observations suggest that the phosphate of phospholipids can contribute significantly to the metabolic pool of inorganic phosphate. Lipid emulsion, most commonly thought of as a major caloric source, should not be neglected when one is confronted with hyperphosphatemia during total parenteral nutrition.

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