New York Dental Consent and History
What are Pop On Veneers?
Pop On Veneers are removable, custom-made covers designed to temporarily improve the appearance of certain natural teeth. They may cover the appearance of chips, gaps, discoloration, or missing teeth, but they do not repair or treat the underlying condition.
Pop On Veneers do not permanently change or move teeth. They are not crowns, implants, dentures, orthodontic aligners, or a replacement for regular, restorative, periodontal, orthodontic, or emergency dental care.
What is the expected benefit?
The expected benefit is a temporary cosmetic improvement in the appearance of your smile. Results, comfort, fit, shade, speech, and useful life vary, and no particular result is guaranteed.
What other options are available?
You may choose no appliance, speak with an in-person dentist, or consider options such as crowns, bridges, implants, dentures, orthodontic treatment, or professionally supervised cosmetic care. Each option has different benefits, risks, costs, and eligibility requirements.
What are the possible risks?
Even when Pop On Veneers are properly made and used, possible risks include:
· A fit, appearance, shade, thickness, comfort level, or speech result that differs from expectations or photographs.
· Temporary pressure, soreness, sensitivity, gum or cheek irritation, mouth sores, gagging, increased saliva, dry mouth, or changes in speech.
· An appliance that feels tight, loose, bulky, unstable, or uncomfortable, or that stops fitting after changes to teeth, gums, missing-tooth spaces, or dental work.
· Allergic or sensitivity reactions to appliance or cleaning materials.
· Cracking, warping, staining, odor, wear, loss, or breakage. A loose or broken appliance or fragment may be swallowed, inhaled, or create a choking hazard.
· Pressure on or damage to teeth, fillings, crowns, bridges, implants, retainers, or other dental work, especially when a condition is not disclosed or later changes.
· Food, plaque, or moisture becoming trapped against teeth or gums, which may contribute to odor, irritation, decay, mineral loss, or gum disease if cleaning and oral hygiene are inadequate.
· Masking symptoms or delaying needed dental care.
Stop using the appliance and contact Pop On Dental LLC and a local dentist if you have significant or continuing pain, swelling, bleeding, sores, a loose tooth, an allergic reaction, damaged dental work, or a sudden change in fit. Call 911 or seek emergency care for trouble breathing or swallowing.
How does the remote dental review work?
I agree to receive dental services from a licensed dentist through teledentistry. The dentist may review questionnaires, photographs, video, messages, impressions, scans, and other health or dental information.
Remote care has limits. Some conditions may only be identified through an in-person exam, X-rays, or other testing. Technology may also fail or delay communications. The dentist may ask for more information or records, require an in-person exam, decline to prescribe, pause the process, or refer me to a local dentist. Online messages are not for emergencies.
I may ask questions about the process, the treating dentist, or the limits of remote care. I may withdraw consent before services are provided, although doing so may prevent the evaluation or fulfillment of my appliance.
What health information do I need to provide?
I confirm that I am at least 18 years old and will be physically located in New York when receiving professional dental services. I also confirm that the information and images I provide are current, accurate, and complete, and that I will report any important changes before using the appliance.
I confirm that the answers I provided about my age, loose teeth, loose crowns or bridges, and allergies to dental impression material are accurate. I will notify Pop On if any of this information changes before I take my impressions or use Pop On Veneers.
I have disclosed any loose teeth, loose crowns and loose bridges. I have also disclosed any known allergies to dental impression materials.
I understand that Pop On Veneers may not fit well if I have active jaw pain, swelling or bleeding and I should contact my local dentist.
I understand that self-reporting and remote review do not replace regular in-person dental care. The treating dentist decides whether Pop On Veneers are appropriate and may require records or clearance from my regular dentist. Approval and a prescription are not guaranteed.
Who is involved in my care and order?
Pop On Dental LLC is responsible for the dental evaluation, clinical decisions, and prescription. PopOnSmiles, LLC provides nonclinical services such as technology, customer support, payment, fulfillment, and manufacturing coordination. My case may also involve licensed dentists and professional practices, laboratories, manufacturers, technology and payment providers, and other service providers supporting my evaluation, appliance, or order. Together, these are the “Covered Pop On Parties.” Each party is responsible only for its own role, and nonclinical parties do not make dental decisions.
How should I use Pop On Veneers?
I will follow all instructions for inserting, removing, wearing, cleaning, and storing the appliance. I will not force it into place; wear it if it is cracked, damaged, sharp, or no longer fits; alter or glue it; expose it to excessive heat; or allow anyone else to wear it. I will continue regular dental checkups. Changes to my teeth, dental work, or oral health may require a new evaluation, impression, scan, or appliance.
How may my information be used?
I authorize the Covered Pop On Parties to collect, use, and share the dental, health, contact, payment, and order information reasonably needed to evaluate me, coordinate care, design and make the appliance, communicate with me, process payment, support my order, and comply with law. Applicable privacy notices and any required separate authorizations still apply. Electronic communications carry some privacy and security risk even when reasonable safeguards are used.
What am I agreeing to?
By submitting my order, I electronically sign this consent and confirm that:
· I have read and understand this consent and had the opportunity to ask questions.
· I understand the purpose, expected benefit, limitations, alternatives, and possible risks of Pop On Veneers.
· I voluntarily consent to the remote dental evaluation and, if prescribed, the fabrication and use of Pop On Veneers.
· This consent applies to Pop On Dental LLC, PopOnSmiles, LLC, and the other Covered Pop On Parties for their respective roles in my case.
· I agree to the Binding Arbitration clause listed in the Terms of Service.
· My acceptance may be recorded with the date, time, order or account details, technical information, and the version of this consent shown to me.
Prices, payments, refunds, remakes, shipping, warranties, and other purchase terms are governed by the written terms presented at purchase. Nothing in this consent waives a right or professional duty that cannot legally be waived.
What if I have questions or concerns?
Questions about the dental evaluation or prescription may be submitted through the website or patient platform. Questions about payment, manufacturing, shipping, or customer support may be directed to PopOnSmiles, LLC through the contact information on the website.
Information about filing a professional-conduct complaint with the New York State Education Department is available at NYSED Professional Misconduct Enforcement. For information, call 1-800-442-8106 or email conduct@nysed.gov. Complaints must be submitted in writing and cannot be filed by telephone.
Updated August 27, 2026