It is our unconditional pledge to you that we shall remain your partners for life in achieving your optimal oral health.

Our practice is committed to provide you and your family with the best possible dental care available.  Every member of Dr. Michael Bailey's staff takes pride in providing quality dental treatment in an utmost professional manner.

Our commitment to excel in our profession is further evident by our unique approach to stand behind our treatment to you.  As a result, we offer a limited dental warranty for the investment you have made in preserving your oral health.

Our goal is to educate you in preventing further tooth decay and to treat your current dental needs.  The treatment recommended by us for oral health depends on individual condition.  As a result, each treatment will be carefully customized after thorough diagnosis.  It is imperative that you continue home care of  your teeth and gums in addition to scheduling your routine dental cleaning and professional exams as recommended by our office.

Just as a reminder let us remind you that the final ownership of your oral health rests on you.  Long term success of our caring treatment greatly depends on how sensitive you are to your oral health.

Treatment Covered
By Limited Dental Warranty

Dental Sealants - We will repair or replace sealants for a period of ___ years from placement date.
 Patient's responsibility - You must keep the prescribed regular recall appointments (minimum 6 months) for routine professional exam, X-rays and cleaning at our office.

Crowns, Bridges, Onlays, Porcelain, Veneers - We will replace or repair the same type at no charge to you during these ____ years.  If a veneered or onlayed tooth is damaged or decayed to the extent that a crown is necessary, the fee originally paid for the veneer or onlay will be applied toward the crown.  You will only pay the difference.
Patient's responsibility - You must keep the prescribed regular recall appointments for routine cleaning, x-rays, and professional exam.  This does not include accidents and willful damage to the prosthetic which could affect normal teeth.  We can not predict if and when nerve treatments may be required on the covered tooth.  If needed this would be additional fee.

Composite (Tooth Colored Fillings) -  If the composite restoration fails, we will replace or repair it for the period of ___ years from the replacement date.  If the tooth breaks and requires a crown or onlay, we will credit the cost of the filling towards the crown or onlay.
Patient's Responsibility - You must keep the prescribed regular recall appointments (minimum 6 months) for routine professional exam, x-rays and cleaning at our office,  We cannot prognosis if and/or when gum or nerve treatments be required on the covered tooth needed, they would require additional fees. 

Dentures and Partials - We will repair dentures and partials for a period of ___ years from the replacement date, if a tooth chips, breaks or flange breaks under normal use.  This warranty will not apply to any accidents and dropping your dentures.
Patient's Responsibility - 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 be seen at the prescribed recall appointments in our office.  Routine professional exam, x-rays and cleaning. 

Patients Name:  __________________________
                   Your prescribed recare appointment frequency is every:
                                      2 months
                                      3 months
                                      4 months
                                      6 months
                   12 months (complete dentures only)