ASK THE EXPERTS
HOW DO I SELECT A COMMERCIAL DENTAL LABORATORY?
QUESTION
I have just opened my practice in a new community and have been bombarded with contacts from laboratories in the area.  I have little experience in knowing how to determine which is the best laboratory for me?   There are large variations in cost and size of labs.  How should I go about finding the right one for me?  What guidelines should I use?

ANSWER

To help with this task, I would first visit the commercial dental laboratories, both small and large, in the vicinity. Walk through the laboratories and see the quality of work being produced. Observe the quality of dental work being sent to each laboratory. Does the laboratory meet your parameters in terms of clean, sharp preparations and casts? What are your quality standards? Examine the laboratory work completed and ready to be sent out. Is it clean and orderly as well as being meticulously wrapped to prevent breakage?

Interview the technicians and ask how much individual attention your work will receive and which technician will be responsible for it. Will there be any problem talking to the person in charge of your cases?

Will the same technicians always be responsible for your work? Ask if all work is done on site or if some is subcontracted out to other laboratories. What is the turnaround time for the various laboratory procedures? Will the laboratory deliver the work on or before the promised date? Is there usually a good excuse for late work?

The next step is to ask dentists, especially any prosthodontists in your area, which laboratories they use and why. If there are not prosthodontists in your area, ask other respected colleagues, the local dental society, hospital dental departments and the prosthetics department of a nearby dental school for recommendations.

You should find a laboratory or laboratories whose services are the least problematic. Usually, you cannot limit yourself to one laboratory but must use multiple laboratories. More individual attention will be provided by a small laboratory. Large laboratories can provide individual attention but, usually, the larger the laboratory, the more assembly-line type of production is used. Find out the fees of the laboratories you are considering. The fees charged are typically customary for your area, but they also may be highly competitive.

Ask for the technicians’ qualifications. They should be certified dental technicians or hold a Master of Dental Technology certificate and be active members of the state and local technicians’ organizations. Ask the technicians if they attend laboratory and/or dental meetings as well as other continuing educational programs. Do they volunteer at a hospital or dental school, and are they members of the faculty?

 

 Finding a good laboratory can be quite frustrating, since it is a trial-and-error experience. I suggest that you first send a removable prosthesis rather than a fixed one to a new full service laboratory. It is easier to remake the removable prosthesis if not fabricated properly than it is to start over with a fixed prosthesis. Make sure that the laboratory understands that if the work is not up to standard, no fee should be charged. If a remake is required because of the technician’s error, a fee should also not be charged.

Ira D. Zinner, D.D.S., M.S.D., is a clinical professor, Division of Restorative and Prosthodontic Sciences, and director, Full-Month Rehabilitation Course, New York University, College of Dentistry, New York. He also has a private practice in prosthodontics. Address reprint requests to Dr. Zinner, 115 E. 61st St., New York, N.Y. 10021.

JADA, Vol. 130, March 1999

ANSWER
A dentist must consider several key factors when selecting a dental laboratory. To narrow the selection, he or she must first ask several questions:

  • What kind of services do I provide? Conventional dentistry or state-of-the-art advanced restorative dentistry?
  • Is the bulk of my practice fee for-service or managed care?
  • What are my fees in relation to laboratory fees?
  • Who are my patients and what are their expectations?

Fees. The fees for dental services differ according to the economic status of the area in which the dental office is located. This is an important factor when deciding which laboratory to choose. Some laboratory fees may exceed the limits of what some dental offices can support


Location. The location plays a role, but not always a significant one, in selecting a laboratory.

The benefits of close proximity include

  • discuss restorations first hand;
  • the ability to confer with a technician about a difficult shade; the possibility of quick adjustments;
  • the ability to support local businesses.

   


 If there is more than one local laboratory to choose from, the dentist should make an appointment to visit several technicians in each laboratory and evaluate cleanliness, equipment moderately certification of the laboratory and educational qualifications of the technicians.
    If no local laboratory is found to be suitable, it may be necessary to send out the laboratory work. With the safety and efficiency of today's delivery services, distance does not significantly hinder the timing of work. In fact, dentists can communicate with technicians by electronic mail, telephone or facsimile to ensure that specifications are maintained.

Expertise. In finding a high quality laboratory, a dentist should inquire about the degree of continuing education in which the laboratories' technicians participate. A certified dental technician has been tested and standards have been met, denoting expertise in his or her specialized field. A certified dental technician is required to obtain a minimum number of continuing education credits annually. Some technicians pursue a Master of Dental Technology certificate, which ensures expert training in all areas of laboratory procedures, including jaw movement and gnathology.

Technicians who are not certified are not required to further their education err skills or familiarize themselves with up-to-date technology.


Materials. Dentists should question the laboratory about the materials used, including metal type (for example, base, noble or high noble), physical breakdown and alternative materials. Does the metal contain any products to which patients might be allergic? The dentist should inquire about the porcelains used, obtaining trade names and determining whether they are high-fusing or low-fusing. They should ask about the type of denture tooth materials used (that is, porcelain, composite, acrylic resin), the type of denture base material used and the processing method (that is, injection, traditional flask, microwave or pour technique).


 Service. Another important factor when choosing a laboratory is service. Although every laboratory will insist that their service is outstanding, dentists will be able to verify this only by actually using the laboratory. Work promised for a certain date should be delivered on that date, or the laboratory should telephone well in advance to explain why the work could not be completed on time.
    Dentists should select a dental laboratory that best suits their practice and needs. After carefully researching various dental laboratories, however, the dentist can be sure of quality only after actually using their services. By doing this, as well as visiting the laboratory (if local), reviewing its credentials, communicating with qualified personnel, evaluating fees, and being assured of reliability and availability of services, a dentist can feel confident in the laboratory chosen. ·

 

This Article appeared in JADA, Vol. 130, March 1999
Robert Winkelman, CDT, MDT, is owner of Fort Washington Dental Lab. Inc., 467 Pennsylvania Ave., Suite 102, Fort Washington, Pa. 19034 Address reprint requests to Mr. Winkelman.