While the idea of a 5 year guarantee looks like a nice concept- it is wrought with many flaws. The lifespan of a crown (or any dental restoration) depends on many factors, only some of which are under the dentists control. These factors include quality of laboratory work, quality of procedurural work done, condition of the tooth in question to start with, medical condition of the patient, home care performed by the patient, does the patient return regularly for check ups to monitor the restoration and quickyl and easily correct small problems before they cause a faiure, patient habits (such as never brushing or bruxism) and so on. I will illustartate several situations where a crown may fail due to no fault of the dentist or the laboratory.

1. Trauma- accidental fracture of the restoration or the underlying tooth due to excessive forces of trauma

2. Bruxism- what if a patient refuses a gold crown for a second molar (recommeded because it can't break) and chooses a porcelain crown that later breaks because of undue stress from bruxism

3. Root canal therapy- some crowns need root canals after they are completed. A hole must be drilled through the crown to do the root canal- this can weaken the porcelain and cuase it to frature

4. Poor home care and recurrent caries under the crown margin can cause a crown to fail

5. The patient insists on trying to save a tooth that is nearly hopeless, so the dentsist does his best, in fact does it perfectly- and it fails after a few years- the patient was informed and knew the crown would likely not last 5 years to start with- and is happy with 2 or 3 years

These are a few situations where, for reasons beyond the control of the dentist, a crown may fail. Some of these are a result of poor decisions on the part of the patient after being informed of options available. In each case, to force a dentist to replace a failed crown would be inappropriate.

Most dentists just do the right thing anyway. If my patient were to have  a crown fail within 5 years, we would have a discussion as to why. If I felt there was any fault of mine involved, I would offer a resonable solution- like replace for free or maybe charge a new lab fee. This is the free market and those who don't stand behind their work will weed themselves out of the mix. You cannot legislate ethical and good behavior- but you can punish the masses for poor behavior of the few. Dentists, for the most part, will do the right thing.

Do not go down this path, it will only lead to confusion, higher costs, and patients not getting what they want. None of these are in the best interests of protecting the public.