I purchased a practice one year ago from a retiring dentist. He left the state a few weeks after I arrived. I soon discovered that my predecessor had treated posterior teeth with a crown material intended for anterior teeth. Several patients were experiencing cement failure or fracture of these crowns. Initially, I did not charge for recementation and even remade a few of the crowns. I now am faced with a dozen patients demanding new crowns. Records show all of this work to be less than two years old. I feel that I do not owe these patients more than my best care. After all, the crowns were placed by another dentist, my predecessor. Since he is no longer in the area, they will have to either accept my offer or see another dentist. A few of the patients have elected to leave the practice. Others have accepted treatment but are not happy with my decision. One even filed a complaint with our local dental society. I was approached by a dental society officer who suggested I retreat all cases for reduced fees or free, depending on the date of original crown placement. Am I unethical for asking a reasonable fee for my services? I have extensive debt, and the laboratory fees and chair time for re-treating patients will be difficult to absorb. Why should I be required to correct problems caused by my predecessor? This can be a challenging professional dilemma for new dentists. From what you have described, the failures do not appear to be caused by patient neglect but rather by a dentist's decision regarding materials. There are legal, ethical and professional issues you should consider. You have an opportunity to solve problems, earn respect from your patients and maintain your professional image. Your attorney can advise you of your legal obligations, which are likely to turn on the terms of your purchase contract and state law. If you purchased the assets, good will and liabilities of the business, you might be required to meet the obligations of any implied warranty of dental treatment. Your contract may have built in some practical protection for you if that is the case. For example, money may have been placed in escrow by the seller to cover treatment failures, or there may be a provision requiring the seller to help in this situation. Even if you are not required legally to retreat these patients for reduced fees or free, asking them to direct their concerns to your predecessor could be harmful to you and your profession. Consider the potential damage to your practice and image that could occur when a single patient leaves your care because he or she believes he or she has been treated unfairly. The ADA Principles of Ethics and Code of Professional Conduct (ADA Code) imposes no ethical mandate on what must be done here, but it does offer some guidance about what might be done beyond what the law may require. Should you elect to do more for your patients that is required by law, your attorney could help you make sure that you are not creating undue liability by doing so. Section 5 of the ADA Code, Principle: Veracity, states that you have an obligation to be forthright and truthful about a patient's condition and treatment options. Explain the problem to each patient, without assigning blame. Your predecessor may have had good intentions in using the materials chosen. Most patients will appreciate your candor and knowledge. Section 4 of the ADA Code, Principle: Justice, states that a dentist has a duty to treat patients fairly. Consider the patients' oral health problems and their perspective on the failed treatment. How might you see this situation if you or a family member experienced the same treatment circumstances? How would you want or expect your dentist to respond? Section 3 of the ADA Code, Principle: Beneficence, states that a dentist “has a duty to act for the benefit of others” and “to put the patient's welfare first.” This can be challenging to your pocketbook and your pride. You should consider designing an individualized treatment plan for each patient, taking into account dental health needs, the time spent in treatment and the fees already paid. Although your situation may seem challenging, it offers an opportunity to help your patients and to establish a reputation as a professional who places patients' oral health above his or her own financial interests. If feasible, I suggest that you honestly explain the situation to each patient without leveling unjustified criticism at your predecessor. You may decide to offer to do the work for no additional fee, or perhaps for just the laboratory fee, in as timely a manner as your schedule allows. Do your best work with your best materials and your best chairside manner. Ultimately, your patients, your practice and the profession will benefit from your ethical conduct, fairness and consideration of your patients' welfare. Whatever you pay in chair time and laboratory fees likely will be returned in patient referrals, good will and enhancement of your image among your patients and peers.