No dental filling, crown, denture, or whitening procedure lasts forever. Recently, unfounded claims have been made by some dentists that if specific criteria are followed and if people do exactly as they are told that dental restorations last “a lifetime.” To some extent, this is true…for the lifetime of the restoration or the prosthesis. Any promise otherwise is unfounded, unethical, and often made for the purpose of soliciting business.
All restorations have expected lifespans. Dental literature and public websites are replete with “common life expectancies” of various restorations. There are no indications, from what I have discovered through a thorough literature search, that any restoration can be expected to last a human lifetime; this is common knowledge among dentists. Although different articles may differ in precise number of years that different restorations may be expected to last, all of them disclaim that uncontrolled factors such as oral hygiene, susceptibility to disease, and technique dramatically affect the expected lifespan. Some estimated lifespans for common restorations are as follows (summarized from multiple sources):
- Crown: 5-20 years
- Resin (tooth-colored) filling: 2-10 years
- Amalgam filling: 7-20 years
- Gold filling: 7-20 years
- Porcelain Veneer: 7-10 years
- Whitening: 1-3 years (regular touch-up required)
- Dentures: 3-7 years
Obviously, many of these last much longer than expected. However, sometimes they do not live up to their expectations. Success or failure depends on several factors. Personally, I have seen good restorations that I placed in good patients who come for regular recare fail for no obvious reason, and I have seen what I considered to be lesser quality restorations than would likely outlive their expected lifespan. The question is: how can anything artificial that man can place outlast what God created in the first place?
The same is true for the treatment of periodontal disease. Gum disease can be treated and managed, but it cannot be cured. Even when patients are absolutely compliant with all recommendations and keep all appointments, gum disease sometimes gets worse. Any promise that it will not is unfair and deceptive.
The only absolutes in healthcare are birth and death. The rest is dependent on each individual patient, the diagnostic capabilities of practitioners, and the techniques available at the time. Dentistry involves both artistic skills and the application of scientific principles. Wise scientists and clinicians understand that there are no absolutes, only tested theories. Therefore, no guarantees are possible for any therapy that we provide.
It is wise to take caution whenever claims of warranty are offered or implied in healthcare, as we know that they are unfounded and unethical. Dentists are bound by a code of ethics that requires us to treat patients fairly, offer them the ability to choose their own care, to do nothing that would harm our patients or leave them in a worse state than they presented to us, to act for the benefit of our patients, and to act in a manner that upholds the integrity of our profession. Decisions to treat, retreat, or not treat should be based on these principles
Therefore, many dentists may choose to refund full or partial credit for failed restorations that do not function as they should, and some may choose to prorate remakes for defective restorations within a reasonable time frame. Sometimes, restorations and prosthesis that were in no way defective do not last as long as expected due to individual factors. In such cases, it would be reasonable that the full fee would be assessed for replacement. The onus is on the dentist to determine what is appropriate in each case. Therefore, if a dentist has earned the reputation for being ethical and trustworthy, then there is no need for impossible promises to bring patients in the door.
If you are interested in learning more about dental restorations or you’re due for your six-month cleaning, be sure to schedule an appointment with Dr. Huff.