Great Expectations: Navigating Warranties and Guarantees in Dentistry

POSTED JUN 17TH, 2021 IN 2021, THE WIRE, THOUGHT LEADERSHIP

Kiran Madesha, Legal Advisor, dentalcorp; Kristy Pilatzke, Risk and Compliance Officer, dentalcorp

Every dentist aims to please by providing their patients with optimal treatment outcomes. This dedication to success can sometimes lead a dentist to offer patients a guarantee (a promise of a satisfactory outcome) or a warranty (a time-limited agreement to replace, repair or refund a defect in material or workmanship). Other dentists may feel obligated to offer a guarantee or warranty when practicing in a competitive market or in response to a patient’s request. Whatever the reason, it is essential to remember that in healthcare—and dentistry is no exception—results are never guaranteed. Despite one’s best efforts, there are multiple biological conditions that might affect the evolution of the treatment and its outcome. 

Guarantees or warranties are most often offered for restorative or prosthetic treatments such as implants, crowns, bridges, fillings, or veneers. However, the success of treatment depends on many factors, a number of which lie outside the dentist’s control, including the patient’s oral hygiene, habits, substance use, the presence of comorbid conditions like osteoporosis or dementia, adherence to post-operative instructions, and dental trauma. Dentists who have practiced long enough know that the human body is always capable of surprises, and treatments may fail for no apparent reason. Even in the best conditions, dental restorations and prostheses may need to be replaced after a certain amount of time.

Patients also play an important role in the success or failure of their own treatment outcomes. Occasionally, a patient will reject a perfectly executed denture or bridge, to cite just two examples, due to subjective, evolving aesthetic preferences, the way they feel, fit, or function. Whether or not they follow their aftercare instructions is also a key factor, and dentists should be very careful to avoid arrangements that may disincentivize patients from looking after their dental treatments or overall oral health.

While being accountable is the hallmark of a true professional, dentists should avoid creating unreasonable expectations for patients. Practitioners should keep the following in mind when managing treatment outcome expectations with patients.

* Never guarantee success. Certain dental regulatory authorities deem it unethical to guarantee the success of dental treatment or services. Guaranteeing dental treatment may invalidate your professional liability insurance, and an ill-advised guarantee could leave a dentist personally liable for not only the cost of remedial work—including work done by other dentists—but even legal defense fees.

Even after treatment has failed, simply redoing the same treatment may not be prudent or feasible. In such situations, the only assurance that may fairly be conveyed to a patient is that the clinicians will use all their professional judgment, training, and experience to seek the desired outcome. If a dental laboratory is willing to provide a free replacement bridge or denture, that benefit can be passed on to the patient. However, such benefits should not be phrased as a guarantee of the underlying work or a promise to fix anything else that might possibly go wrong. 

IMPORTANT:

Please be aware if undergoing the replacement of any part of your dental treatment under the terms of the guarantee, this shall be in the original colour as consented to and signed for when the treatment was originally decided upon and provided. If desiring a colour change, this will only be provided at the full cost.

The Guarantee will be invalidated in the following circumstances:

* If oral hygiene is neglected;

* If the patient does not have a routine dental check-up to include a Panoramic X-Ray and a Scale and Polish at least once a year (invoice required);

* If the Dentists’/ Oral Surgeons’ instructions are not followed;

* If the patient fails to fulfil their payment obligations;

* If subsequent treatment is carried out to the treatment originally effected in the local clinic without prior authorisation (with the exception of Scale and Polish treatments);

* If removable restorations such as partial or full dentures are not kept and maintained properly;

* Temporary teeth by their very nature cannot be guaranteed against for either breakage or the need for re-cementation;

* If the patient’s gum tissue or bone recedes or deteriorates;

* If nail biting is deemed to be a contributing factor to your dental issues;

* Not attending any appointment given by the local dental clinic will void the guarantee in its entirety;

* The patient is involved with contact sports or sporting and associated leisure activities that may cause dental health issues or injury;

* Smoking is a contributing cause to your dental issues;

* The indulging in any activities or drugs that are known to artificially raise or reduce your blood pressure;

* In the event the patient wears tooth/ teeth grillz or jewellery which is attached to the teeth, tongue or lips on a temporary or permanent basis;

* The use of recreational or prescribed drugs or supplements, herbal or otherwise, other than those declared at the time of the dental work carried out;

* In the event of accidental damage, for example dropping the denture or damage by a third party;

* In the event that the same or similar dental issue continues to arise and is therefore considered a recurring or reoccurring issue that may be unrelated to the dentistry itself, the clinic reserves the right to advise you to visit a specialist or a medical professional for further tests that may be directly or indirectly related to dentistry. The responsibility of the costs incurred will be that of the patient. The avoidance of such advice will automatically void your dental guarantee;

* In the event that the Dental Implant migrates to whatever degree;

* In the event that the Bone Grafting is rejected;

* A general illness is present which has or has had adverse effects on the chewing organ, jawbone or tissue to include but not limited to: diabetes, epilepsy, osteoporosis, excessive X-rays, mental disorders or chemotherapy;

* Inappropriate selection of the colour and shape and size of the dental prosthetic or prosthesis by the patient. During the preparation period, patients are given the opportunity to choose their colour preference however, the clinic cannot be held responsible for the decision of the patient if they decide later that they do not like the colour or shape they originally chose;

* Excessive grinding/ bruxism;

* Pregnancy may be the cause of your dental issues;

* Occasionally teeth suffer preparation trauma during crown and bridgework resulting in the need for root canal treatment. The dental clinic is not liable for any issue, which was not visible on the patient’s final x-ray, and was not foreseeable or predictable, at the time of treatment;

* If a substantial gain or loss in weight occurs;

* If a gum shield is provided by the clinic and not worn as advised;

* In the event that the patient was pregnant at the time of treatment and did not disclose their circumstances;

* In the event that the patient is under the age of 18 at the time of treatment and did not disclose their actual age;

* If the patient has been provided with a prescription and the prescription is not obtained or is obtained but not taken as per the instructions provided. In such event, the clinic reserves the right to void any and all aspects of the dental guarantee;

* If the patient fails to return for the completion of dental treatment within 12 months of their last signed consent form, such treatments to include but not limited to, Dental Implants/ Implant Crowns and Dental Bridges after extraction;

* Please note that this guarantee does not cover any other expenses related to travel or accommodation for any agreement7treatment/procedure