This study investigated the quality of restorative care in a group of health center employees. With limitations in sample size, representativeness of the sample, and methods of measuring quality clearly recognized, the results of the study suggest that significant improvements in the quality of amalgams, synthetic restorations, crowns, fixed partial denture abutments, and pontics will probably require advances in the science and technology of dentistry and modifications in the present system for delivering dental care. The impact of a quality review system is unlikely to affect the care provided by the majority of dentists. Quality review should play a role in monitoring the services fo the small percentage of dentists whose care is very inadequate. Admittedly, these conclusions are speculative and are not based on a large body of experimental information. Nevertheless, the evidence that is available is suggestive, and the development of a national policy to monitor the quality of dental care must consider what can be reasonably achieved with a quality assurance system.