What does an implant guarantee cover?

The first layer is the implant itself: the titanium part placed in the bone. Manufacturers usually give a long guarantee for this part, sometimes a lifetime one. But be careful: this guarantee covers a defect in the product itself, such as a fracture or a manufacturing fault. What it covers is replacing the part; the labour, the surgery and the bridgework are not included. The phrase 'implant with a lifetime guarantee' often describes exactly this, and it is not the same as what the patient takes it to mean.

The second layer is the bridgework: the bridge, crown or denture made on top of the implant. Its lifespan is naturally shorter; the material wears, cracks and needs repairing from time to time. That is why a guarantee on the bridgework runs for a shorter time and comes with more conditions. If the word 'guarantee' appears on a quote, the first thing to ask is this: is it a guarantee on the implant, or on the tooth on top of it?

The third layer is the most misunderstood: the biological outcome. In other words, the implant fusing with the bone and staying there for years. No clinic can guarantee this, because the outcome also depends on things outside the clinic's control: smoking, blood sugar, how you look after your mouth, grinding your teeth at night, your general health. An honest clinic does not guarantee it; what it commits to is what it will do if the implant fails.

It is this third commitment that is really valuable, and it is what you should look for in the document. The questions are: if the implant fails, is a new one provided free of charge? Are the surgery and the bridgework covered too, or only the part? How many times will this be done? Written answers to these three questions are worth far more than the word 'guaranteed'.

The conditions that make a guarantee void are also set out in the document, and people do not read them. The most common are: not attending regular check-ups, carrying on smoking, uncontrolled diabetes, not looking after your mouth, and having work done at another clinic. These clauses are not unfair; every one of them genuinely affects the outcome. But you need to know which ones apply before treatment.

Finally, a practical reality: a guarantee means something only if there is a clinic to honour it. For treatment carried out abroad or in a distant city, a document with the word 'guarantee' on it is of no use if going back is not practical. That is why the question about the guarantee should be asked together with the question about follow-up: if a problem comes up, where will I go, and is going there realistic?

These are the points a document should contain, and the ones to ask about if it does not.

Each of the questions below should have a short, written answer.

1. 1

   A guarantee on what?

   The implant itself, the bridgework, or both? Is the duration for each written separately? This first question alone tells most quotes apart.

2. 2

   For how long?

   A separate duration for each layer. If the word 'lifetime' appears, what it covers should be in writing; it usually describes only the implant itself.

3. 3

   What happens if it fails?

   Is the new implant free of charge, is the surgery included, is the bridgework included, and how many times will this be done? The truly valuable part of the guarantee lies in these answers.

4. 4

   Which situations are excluded?

   Not attending check-ups, smoking, uncontrolled diabetes, grinding your teeth at night, work done at another clinic, accidental damage. The list should be written out clearly.

5. 5

   How many check-ups are included?

   A guarantee usually depends on regular check-ups. How many check-ups a year are needed, and whether you have to pay for them, should be in writing; otherwise the guarantee can quietly lapse.

6. 6

   Where do I go?

   Which clinic, how, and within what time if there is a problem. For patients who come from far away, this answer matters more than the guarantee itself.

The following do more than a guarantee document to decide whether a treatment lasts.

These are behind most disputes, and all of them can be prevented.

A guarantee is not a document but an ongoing relationship. These are the things that keep it alive.

1. When treatment ends

   Get the guarantee document, your implant record and the post-treatment X-ray, all together. Keep digital copies of all three as well; years later, these three are exactly what you will need.

2. The first year

   Attend your check-ups and have each one recorded. This is usually the condition of the guarantee; without a record, it becomes harder to prove that you attended.

3. The years that follow

   At least one check-up and professional clean a year. At each appointment, the bone level around the implant is compared on X-rays; this measurement underpins both the guarantee and the treatment.

4. If a problem comes up

   Report it straight away. A problem reported early both stays small and is easier to assess under the guarantee. With a problem that has been put up with for months, an argument starts about whether it was reported in time.

A guarantee is not an item on the bill, but it directly affects the total cost. When you compare quotes, look at these.

How broad the cover is

Only the implant, or the bridgework too, and is the surgery covered? The real difference between two quotes at the same price often lies here.

The cost of check-ups

If the guarantee depends on regular check-ups and you have to pay for them, this item adds up to a considerable sum over ten years. How many check-ups are included should be in writing.

Cover for a replacement

If the implant fails, is the new one free of charge, and are the surgery and the bridgework included? This decides who bears the cost of the most expensive scenario.

How practical it is to make a claim

For patients who come from far away, using a guarantee means travelling. This cost is not written in the document, but it is real; it should be worked out together with the follow-up plan.