CRYSTAL CITY DENTAL CARE LIMITED DENTAL WARRANTY
Our practice is proud of the dentistry that we provide for you and your family. Our goal is not just to correct any dental problems you may have, but to also show you how to prevent dental disease in the future and save you time and unnecessary expenses.
The long-term success of the treatment we provide depends on the care of your teeth and gums at home and keeping all recommended professional cleaning with the recommended time frames. These appointments include periodic examinations, by the dentist, of the teeth, gums, bone, oral cavity, throat, muscles of the head and neck, as well as oral cancer screenings, x-rays, cleanings, and fluoride treatments. The products we recommend for you and the frequency of visits depend on your individual condition. Visits may be every 2,3,4, or 6 months, depending on your oral health.
With that in mind, we offer the following limited dental warranties for the investment you have made in preserving your oral health.
| Treatment Covered by Our Limited Crystal City Dental Care Warranty | Our Obligations | Patient’s Responsibility |
| Dental Sealants | We will repair or replace Sealants for a period of 2 yrs. from the date of placement. | You must keep the prescribed regular Hygiene appointments (usually 6 months) within a 21-day grace period for routine professional exams, x-rays, and cleaning at our office. |
| Crowns, Bridges, Onlays, & Veneers | We will replace or repair the same type of restoration at no extra charge to you during the first 1 yr. from the date of placement. The tooth will be allowed a minimum of 2 replacements within the warranty period. If a veneered or onlayed tooth is damaged or has a material failure to the extent that a crown is necessary, the full fee originally paid for the veneer or onlay will be applied towards the crown. You will only pay for the difference.
| You must keep the prescribed regular Hygiene appointments (usually 6 months) within a 21-day grace period for routine professional exams, x-rays, and cleanings at our office. This does not include accidents, acts-of-God, and willful damage to the prosthetic which could affect normal, healthy teeth. We cannot predict if and/or when gum or nerve treatments may be required on the covered tooth. If needed, they would require additional fees. |
| Composite Fillings | If the composite restoration fails, we will replace or repair it for the period of 1yr. from the date of placement. The tooth will be allowed a minimum of 2 replacements within the warranty period. If the restoration breaks and the surface size changes or the tooth requires a crown or onlay within this 1 yr. period, we will credit the cost of the filling towards the larger filling, crown or onlay. (Warranty is void if the restored tooth was recommended for a crown or onlay originally)
| You must keep the prescribed regular Hygiene appointments (usually 6 months) within a 21-day grace period for routine professional exams, x-rays, and cleaning at our office. This does not include accidents, acts-of-God, and willful damage to the filling, which could affect normal healthy teeth. We cannot predict if and/or when gum or nerve treatments may be required on the restored tooth. If needed, they would require additional fees. If your insurance allows composite replacements with no frequency, we will submit for coverage but waive the remaining patient responsibility within the warranty year. |
| Dentures & Partial Dentures | We will repair dentures and partials for a period of 2 yrs. from the date of placement if a tooth chips/breaks or the flange breaks under normal conditions. This warranty does not apply to any accidents and/or dropping the denture.
| Full upper and lower denture patients must be seen once every 12 months in our office. Patients with some of their own natural teeth must keep the prescribed regular Hygiene appointments (usually 6 months) within a 21-day grace period for routine professional exams, x-rays, and cleanings at our office.
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Disclaimer: What is not covered by the Crystal City Dental Care Warranty
1. Cash refunds for any treatment rendered.
2. Failure or repairs resulting from the act-of-God, neglect, abuse, failure of supportive tooth or tissue structures, improper adjustments of improper dental hygiene.
3. Failure to follow periodic (minimum 6 months) dental visits as prescribed by our office for professional exam, x-rays, and cleanings.
4. Failure to complete necessary dental treatments as prescribed by our office to prevent Gum Infection and Tooth Decay, which tends to spread from tooth to tooth.
5. You must keep the prescribed regular Hygiene appointments (usually 6 months) within a 21-day grace period for routine professional exams, x-rays, and cleaning at our office. Any cancellations must be notified to our office at least 48 business hours prior to your scheduled appointment. Shorter notice of change or cancellations will severely limit our ability to offer another patient their most preferred time. To maintain the warranty, the canceled appointments must be rescheduled to stay within re-care parameters.
6. Incidental or consequential damages, including inconvenience, lost wages, or pain and suffering.
7. The warranty is null and void if the failure of the restorative work is due to abuse or negligence due to any form of mistreatment of the piece. This includes but is not limited to, biting into metal objects, chewing ice, self-adjustments, etc.
8. The warranty is null and void if the restorative work needs to be removed or is damaged due to dental problems or repair with the supporting tooth/teeth, including but not limited to root canals, recurrent decay, etc.
9. The warranty does not include any cost associated with routine maintenance required over the course of its working life.
10. If the doctor determines a night guard/occlusal guard is necessary to maintain and protect your restorative work, the warranty will be null and void if you do not have one fabricated.
All regular and replacement/repair treatment will have to be rendered in our office at
2800 Crystal Drive, Suite 320, Arlington, VA. 22202.
I, _____________________________, acknowledge the receipt of my dental work warranty information.
Date: ________________________________________________