warranty on dental work

ligertigon

Am about to spend 6k on dental work. graft and implant in NI.
However, a signature is required for the treatment plan, and there is a disclaimer that if the implant doesn't work (interferes with root of adjoining tooth) there is NO refund...

Is this the norm?

davo10

ligertigon wrote: »

Am about to spend 6k on dental work. graft and implant in NI.
However, a signature is required for the treatment plan, and there is a disclaimer that if the implant doesn't work (interferes with root of adjoining tooth) there is NO refund...

Is this the norm?

Yip, no warranty on medical/dental procedures, that is why healthcare is excluded from consumer law. The disclaimer form part of "informed consent", you are advised of the risks prior to surgery.

ligertigon

for 6k with no guarantee of any kind, I might have a go at it myself:p

davo10

ligertigon wrote: »

for 6k with no guarantee of any kind, I might have a go at it myself:p

There are too many variables, the condition of the bone, the body's ability to accept the implant, the operator's ability, your occlusion (bite) and its effect on the implant, your oral hygiene, your commitment to having it checked regularly, social and dietary habits, trauma etc. The Clinician cannot guarantee a surgery will work and that applies to every procedure without exception. You have to weigh up the benefits and risks, and then make your decision. Having said that, the success rates for implants is very high, particularly when placed by a qualified specialist oral surgeon, periodontist or implantologist.

ligertigon

I understand. But if implants have a 98% success rate. Can the dentists not take out insurance cover for (1) the materials (2) their workmanship. The insurance cost can surely be passed on to the customer.

If failure is down to neglect on the part of the recipient, then surely that can be indemnified?

davo10

ligertigon wrote: »

I understand. But if implants have a 98% success rate. Can the dentists not take out insurance cover for (1) the materials (2) their workmanship. The insurance cost can surely be passed on to the customer.

If failure is down to neglect on the part of the recipient, then surely that can be indemnified?

In theory Dentists shouldn't need to be indemnified for problems caused by the recipient.

I can assure you as a dentist of 25 years, recipients rarely accept responsibility when things go wrong, it is "always" the clinicians fault. If you feel the failure was caused by negligence, you have the option to seek redress through the courts. I can also assure you that our indemnity costs have risen exponentially over the last 10 years because we are indemnified by companies who also cover Doctors, I have never been sued (touch wood) but my insurance has risen 5 fold in 10 years. Our indemnity is not like car insurance where if you have a claim your premium goes up, we all pay the same amount irrespective of whether we are conscientious clinicians or risk takers.

If it makes you feel any better, even if you have an ingrown toenail removed under GA, you would sign a disclaimer saying you understand the risks and the procedure may not be successful, it's just the way things are in the medical/dental field.

ligertigon

davo10 wrote: »

In theory Dentists shouldn't need to be indemnified for problems caused by the recipient.

I can assure you as a dentist of 25 years, recipients rarely accept responsibility when things go wrong, it is "always" the clinicians fault. If you feel the failure was caused by negligence, you have the option to seek redress through the courts. I can also assure you that our indemnity costs have risen exponentially over the last 10 years because we are indemnified by companies who also cover Doctors, I have never been sued (touch wood) but my insurance has risen 5 fold in 10 years.

I hear you, so would a 2-5% hike on all implants not cover the cost of failure refunds? 5% of €2500 = extra €125 for piece of mind of the recipient. Doesn't seem too complicated, maybe a bookie would hedge it for you! lol

On another note, I notice some overseas surgeries offer guarantees (on osseointegration). It would make one feel more confident as its not offered here...

davo10

ligertigon wrote: »

I hear you, so would a 2-5% hike on all implants not cover the cost of failure refunds? 5% of €2500 = extra €125 for piece of mind of the recipient. Doesn't seem too complicated, maybe a bookie would hedge it for you! lol

On another note, I notice some overseas surgeries offer guarantees (on osseointegration). It would make one feel more confident as its not offered here...

I'm afraid that's an old chestnut, the warranties on "overseas" surgeries. Google "tibor dental high court", when you try to exercise that warranty it is literally not worth the paper it is written on, when they refuse, you have to go to court in that country if they don't have a satellite clinic here.

In regard to taking out extra insurance, if there is informed consent, the recipient is aware of that he risk and accepts it, no need for extra insurance. Again, if there is negligence, court action is an avenue of redress open to you.

If the Clinician is good, no matter where/what country you have it done in, the chances of success are very high, but you as the patient have to accept some risk, no matter how good the treatment/surgeon is, there is always an element of risk beyond the surgeons control, and that burden must also fall on the patient. No surgeon, ever, can guarantee a successful outcome.

ligertigon

21st century implant dentistry has zero recipient financial confidence. Despite 95-98% practitioner success after 5 years.

So I spend €6000 and if it doesn't work, tough.

got it.

davo10

ligertigon wrote: »

21st century implant dentistry has zero recipient financial confidence. Despite 95-98% practitioner success after 5 years.

So I spend €6000 and if it doesn't work, tough.

got it.

On the contrary, 21st century implant surgery has over 90% success rate, that is an exceptional success rate among surgical procedures, you would be hard pressed to find a better success rate for any other surgical procedure. I wouldn't say there is "zero recipient financial confidence", you simply will not get a 100% guarantee for any surgical procedure.

Again, this is precisely the reason for informed consent and signed forms, you are informed of the risks, if you do not accept that it could go wrong, do not have surgery. Your choice.

Oral Surgeon

ligertigon wrote: »

Am about to spend 6k on dental work. graft and implant in NI.
However, a signature is required for the treatment plan, and there is a disclaimer that if the implant doesn't work (interferes with root of adjoining tooth) there is NO refund...

Is this the norm?

I'd agree with the no refund point as the clinician (hopefully) is using good materials and performing the procedures to a high standard. The missing bits in a successful outcome here is the level of patient care and compliance and sometimes just bad luck and bad healing despite all the best treatment and care.

Both of these factors are not the clinician's fault and all of the consequences of these should not fall upon the clinician...

Suppose the clinician places the implant and the patient doesn't follow the care instructions (I HAVE BEEN SURPRISED BY THE PATIENTS WHO DO THIS) or there is an unpredictable bad heal... The clinician has to deal with all of the post treatment care, infection, swelling, procedure to remove implant etc... All of that clinical time and materials have been used (at a cost) and then the patient wants all of the money back too!! The dentist is at a serious loss for that case and (maybe) all because the patient didn't follow the instructions...

Small point, but in your case, you would not be out €6k as I'm sure treatment is broken up into graft/ implant/ crown or bridge. If the implant failed to integrate, you would be out for the graft/ implant fee and would not go on to pay the crown/bridge fee..... If a late failure this often points to patient hygiene issues...

Rather than focusing on the money aspect, have you asked what happens if an implant fails to integrate for this clinic?? Is it bye bye time??

I do not offer money back guarantees, this is medical/surgical care.... I tell patients that if the implant fails to integrate then I will remove and replace the implant free of charge.

btkm8unsl0w5r4

I always tell patient I can guarantee mechanical things and materials, I cannot guarantee their biology. Implants are very successful, however if your one of the 3-5% of patients where it does not work, then failure is 100%. The clinician will have spent the time, the materials and components. And so long as the implant was done properly thats just the luck of the draw.

A failed implant is a big pain for everyone, nobody wants it to work more than the person placing it, however they cannot accept totally YOUR risk. Your own attitude to risk will determine if your a good candidate for treatment or not.

As above the implant is foundation work, the charge for the crown or bridge wont happen if it doesnt work, you will have to pay to find out.

ligertigon

Jacob Juicy Bomb wrote: »

I always tell patient I can guarantee mechanical things and materials, I cannot guarantee their biology. Implants are very successful, however if your one of the 3-5% of patients where it does not work, then failure is 100%. The clinician will have spent the time, the materials and components. And so long as the implant was done properly thats just the luck of the draw.

A failed implant is a big pain for everyone, nobody wants it to work more than the person placing it, however they cannot accept totally YOUR risk. Your own attitude to risk will determine if your a good candidate for treatment or not.

As above the implant is foundation work, the charge for the crown or bridge wont happen if it doesnt work, you will have to pay to find out.

I really do understand all of you.

But no one has addressed the solution of a small surcharge on all implants, to cover the failure on the tiny few, so a refund is possible.

This is regardless of who's fault it is. The refund could be even 50:50 for dentist :recipient. better than nothing, and doesn't cost the practice.
A sliding scale could even be used to take time into account..

Oral Surgeon

ligertigon wrote: »

I really do understand all of you.

But no one has addressed the solution of a small surcharge on all implants, to cover the failure on the tiny few, so a refund is possible.

This is regardless of who's fault it is. The refund could be even 50:50 for dentist :recipient. better than nothing, and doesn't cost the practice.
A sliding scale could even be used to take time into account..

In my experience, the patient doesn't want a refund, they want their implant.

btkm8unsl0w5r4

Warranty =/= Insurance. Warranty covers defective goods, insurance covers risks.

davo10

ligertigon wrote: »

I really do understand all of you.

But no one has addressed the solution of a small surcharge on all implants, to cover the failure on the tiny few, so a refund is possible.

This is regardless of who's fault it is. The refund could be even 50:50 for dentist :recipient. better than nothing, and doesn't cost the practice.
A sliding scale could even be used to take time into account..

I doubt there is an insurance company which insures against medical/dental procedure failures, certainly I've never heard of one. There are too many variables. I take it that you are not suggesting that the dentist charges more to warranty the implant? That would be crazy, the failure rate is so low that patients would be aghast at being asked to pay €125 more the same way consumers hate being asked to buy insurance policies on electrical goods.

Again, you consider these risks when deciding on treatment, if a 2-5% risk of failure is too much, surgical procedures are not for you.

Fishorsealant

The only way to have no complications or risk from a procedure is not to have it.
If you do a procedure enough times you will eventually encounter complications.
Statistics are great but they refer to the population not the individual!

This is why it is called informed consent.
While there are often many factors which can be controlled there will always remain factors which are uncontrollable and unpredictable. At the end of the day you have to identify the risk to the specific patient you are treating.

People often try and apply thought processes from other everyday activities to healthcare and they just don't always coincide. People forget about the patient specific factors and how healthcare is tailored towards the individual. No two patients are the same.

Nothing in dentistry lasts forever , nothing is guaranteed , nothing is 100% fool proof. This is why it is termed for example definite restorations not permanent restorations.

When you take everything into account, it isn't reasonably practicable to guarantee treatments.

ligertigon

many thanks for input. guess its roll the dice time!

davo10

ligertigon wrote: »

many thanks for input. guess its roll the dice time!

"Roll the dice" with 90%+ chance of a "win", that's good odds.