DentaltownUK June 2018 - 5

mike gow

editorial

If You Want a Guarantee, Buy a Toaster
In the 1990 film The Rookie, Clint Eastwood's
character, Nick Pulovski, says: 'If you want a guarantee,
buy a toaster.' While it is probably unwise to say it this
bluntly to any of your patients who ask about guarantees
for treatment, what do you say?
This topic of dental treatment guarantees crops up
from time to time on the Dentaltown message boards
and in dental social media groups. Most dentists agree
that it's generally unwise to offer a written guarantee
for most dental treatment; some go so far as to tell
patients that the only guarantee they will offer is that
at some point it will fail-it is just a question of 'when'
rather than 'if'. The general consensus, therefore, is to
avoid giving any guarantee. What do you say?
For most of the dentistry I provide, I favour a verbal
statement along the lines of, 'My expectations are that
the restoration should last five-plus years, but if any
issues occur within the first year that are not due to
parafunction, habits, misuse or lack of care-and you've
attended all your check-up appointments in that time-
then I'll correct it or replace it at no charge, as a gesture
of goodwill'.
I feel it's important to use the words 'five-plus' when
giving lifespan expectations. Many dentists say,
'five to 10'. The risk is that if you say this, the patient
will hear '10' or feel that if it fails at five then this was
at the low end.
I know this now, because it has happened to me with
a failed restoration after some seven years and the patient
saying, 'You said it would last 10 years'. Saying 'five-plus'
avoids those issues. Specifically stating that this offer is
a 'gesture of goodwill' is important, also, because it
highlights that it is not a guarantee. This needs to be
crystal-clear to the patient.
Obviously, there can be a degree of flexibility in your
gesture of goodwill. In reality, if something fails within
the second year, the same criteria are met and I really
wouldn't have expected something to fail so soon,
I'll consider the merit of extending the gesture of goodwill
in that case.
Alternatively, depending on the restoration, timespan
and case, I'll sometimes compromise and charge a small
fee to cover materials costs for the repair or replacement.
I often find that it is useful to have this option if you
find yourself in a grey area (e.g., an unexpected 'early'

failure in Year 2 or 3) in a regular attender with good
oral hygiene on no parafunction or habits, etc., that may
have affected longevity.
Patients will often accept this as a fair compromise
when you explain that the restoration failed earlier than
you expected but after your usual goodwill period,
despite the fact that you were happy with your work,
felt the patient had been looking after it well and they
had been attending regular check-ups. If it's a crown (or
other lab-made restoration/prosthetic) that has failed
earlier than expected, depending on the case and reasons
for failure as above, there is the option of just charging
the lab fee to the patient for a remake.
Fortunately, it doesn't happen very often to me, but
when it does I feel it's a good investment to ensure my
patients feel that they have been looked after and dealt
with in a fair way. How you deal with 'failures' and
issues is obviously up to you and your practice policy;
however, bear in mind that it can be an opportunity to
be a practice builder.
Patients with issues whom you bluntly tell (Clint
Eastwood voice optional), 'If you want a guarantee,
buy a toaster' will be more likely to complain, and to
tell others to avoid you. Patients who feel looked
after are more likely to feel satisfied, remain loyal and
recommend you to their friends and family. Be clear,
however, that what you offer is a goodwill gesture rather
than a guarantee.
There are some fantastic articles in this issue of
DentaltownUK. Thank you again to all our contributing
authors, and also to our sponsors. I would especially like
to take this opportunity to thank our Student Editor,
Kishan Sheth, who is finishing his final exams and will
graduate this year.
We are delighted that Sheth has
accepted a position on the honorary
editorial board and will continue to
work with us.
We also look forward to working
with a new student editor after the
summer! If you are a dental student
and are interested in the highly coveted
role of becoming DentaltownUK 's next
student editor, please go to the Student
Section in this issue to find out more. ■

by Mike Gow BDS (Gla) MFDS RCPS (Gla) MSc Hyp (Lon) PGCert (Edin), Editor, DentaltownUK magazine
dentaltownuk.com \\ JUNE 2018

http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK June 2018