I am sure the petitioner has good intension to protect the public from bad dentistry, but why only five years?  Why not ten, twenty or thirty?  I hate to see C&B failures, but I cannot be held accountable for all the failures I have seen in work of any age.  What C&B failure data does the Commonwealth have to suggest the need for a change?  I would be against any change to current rules since the factors causing early failure of C&B are multifactorial.  Who will judge what failures are related to patient host factors, which are related to material or laboratory issues, and which were dentist errors? In the early 1990 I did a bunch of Procera Alumina crown, many of them failed 8-9 years out.  I hated to see these fail but we were told by manufactures that these crowns worked and had lifetimes equivalent to PFMs.  They were wrong. 

 Are you asking dentist to be responsible for patient’s failure to seek routine dental care, or if they fail to practice proper oral hygiene?  What happens if the patient’s host oral flora changes due to hospitalization, diseases which lead to immunocompromised states, changes mental status or cognitive abilities, or accidents?  How about material failures or poor laboratory workmanship that only show up with time?  Will laboratory also be forced to warrantee their work, or will the burden just be borne by the dentist?  Medical doctors don’t give any warrantees if the surgery fails, cancer comes back or if a patient contracts a nosocomial infection which requires additional treatment and fees. We will be forced to increase our fees to cover this additional liability.

We currently have mechanisms to address patients complaints due to a lack of proper retention and resistance form, incomplete decay removal, bad workmanship and improper fix.  Patients can file a complaint with the BOD and an investigation will follow. We have all seen what we consider bad work, but in a court room these are just our opinions and do not represent the standard of care.

It should be left up to the individual dentist to determine his/her office policies.  If this were an appliance or electronic equipment the consumer would be allowed to buy an extended warrantee at their discretion.  I personally warrantee my work for five years when the C&B is fabricated in the USA and the lab generally covers the replacement crown.  When price is the only consideration and off-shore lab is used, we do not have any margins left to offer any warrantee, since those labs done offer one to us.  If you are interested in helping the public the BOD should determine what types of failures have occurred and which materials are involved.  Maybe a class-action law suit is in order.

Dag Zapatero, DDS, MAGD