Hidden costs: Working with a dental lab

January 2010 | dentalproductsreport.com
web exclusive

Hidden costs: Working with a dental lab

Communication is key to saving you, your lab technician and your patients time and money.

by Renee Knight, Senior Editor

Photo: Andersen Ross/Getty Images

If you’re not communicating with your lab technician, you’re losing money.

Between time spent on re-makes and time lost going back and forth with your lab after you’ve sent the case in, not communicating with your lab on the front end can be a costly mistake. As a dentist, chair time is your biggest commodity, cosmetic dentist Dr. Robert Lowe said. If you’re not at chairside or if you’re constantly re-making cases when you are, you’re costing yourself money.

Why it makes a difference
When you don’t communicate effectively, there’s a good chance your lab won’t give you what you need. And it’s not because the technicians there aren’t good at what they do. They’re not magicians, and if you don’t provide them with the information they need and then opt not to return their calls or have an assistant who isn’t knowledgeable about the case handle it, it becomes difficult for them to do the level of work you and your patients expect. You can’t expect your lab to “make it work,” which, unfortunately, is what many dentist do, said Daxton Grubb, President of R-dent Dental Laboratory.

“That old school mentality, along with not being able to get the doctor on the phone is really where it lies,” Grubb said. “That causes us to move in a direction we shouldn’t, unless we’re into gambling. Let’s minimize our expenses now. Let’s get the patient back in and re-evaluate before we lose time and spend money on something that won’t work.”

You have to be willing to work with your lab. If your lab technician tells you there’s something questionable about the impression you sent, you should listen, Grubb said. Maybe the patient didn’t bite down all the way or maybe the margins don’t look right. Regardless of what the problem is, if your lab technician tells you a new impression is in order, then it’s time to call the patient back in. This might seem like an inconvenience, but it’s a lot easier than starting over when you realize the restoration simply isn’t going to work.

What you should provide
Many dentists send their lab an impression and a prescription, Dr. Lowe said, but that’s not enough. Often, the lab will provide you with a check list of everything the technicians need to complete a case, which usually includes a photo of the patient’s full smile and a picture of the patient’s full face.

“In today’s digital world with digital photos, there’s no reason not to. I send a CD with intraoral pictures with every case,” Dr. Lowe said. “That’s the way my technician sees my patients. It’s not just a picture of the tooth we’re trying to match. I send a picture of the patient’s face, of the patient’s full smile, how much of the gum line shows in the smile and how many teeth show in the smile. The technician never gets to meet the patient unless the dentist sends photographs.”

And when it comes to the prescription, don’t just leave a note telling the technician to call you. It’s best to provide the necessary information up front, but most dentists don’t do that, said Bennett Napier, Co-Executive Director of the National Association of Dental Laboratories. According to an NADL survey, 2/3 of the respondents said clinicians routinely give them incomplete prescriptions.

If the lab doesn’t get this information up front, it will take longer to complete the case, Napier said. That means you won’t get your case back when you expect to, which only leads to anger and frustration.

Communication and cosmetics

When it comes to cosmetic cases, communication is even more important, said Daxton Grubb, President of R-dent Dental Laboratory. If you’re doing a six-unit veneer case on a young female patient, this isn’t a cheap case and your patient likely has high expectations. She’s thinking Hollywood. You can’t just take the impression and tell the lab you need six veneers. These cases take a few more steps, including sending temporaries to let the patient try in to see what they will look like. If you don’t, Grubb said there’s a 50/50 chance of something going wrong.

And before you can get to that point, you have to give them more than an impression and a picture of the movie star the patient wants to look like. Don’t make the technician assume things. If you isolate as many variables as possible, you’ll have a higher chance of success.

This might take an extra appointment or two, but those appointments take much less time than having to redo what could be a $12,000 case.

“That’s a nightmare,” Grubb said. “You’ve lost confidence in doing this kind of work, and the patient had a bad experience.”

Be approachable
Your lab technicians shouldn’t be afraid of you. Dr. Lowe makes sure the technicians he works with know they can call if they have a problem or questions. They shouldn’t be afraid to tell you about problems, and you should be comfortable talking with them about any issues that come up. If you’re not happy with something the lab did and you just get angry about it, the situation isn’t going to change. You’re just going to get more and more frustrated when the problem continues and move your business to another lab in an attempt to solve the problem. In most cases, it doesn’t need to go that far. If you talk with the lab about the problem and how you’d like it resolved, the problem likely will go away much quicker.

It also doesn’t hurt to let the lab know the best way to reach you when the technician needs to talk out a problem, Grubb said. Let the lab know if you’d rather communicate on the phone, via text message or e-mail.

It’s not too late to change
If you’re what Grubb describes as a “hopper” who moves from lab to lab because none of them can meet your expectations, maybe it’s time to take a look at how you do business. Are you communicating and your lab just isn’t getting it, or are you doing the minimum and still expecting quality results in return? If communication is lacking on your part, it’s time to change the way you think about your dental lab. This is a crucial relationship, and you have to respect the lab technicians and know you trust them with your cases.

Building a strong relationship with your lab starts with both sides knowing what the other expects and needs, Dr. Lowe said. Interview your technicians and make sure you establish expectations for both sides. If you lay out your expectations up front, they’ll be more likely to meet them and vice versa.

“The lab technicians blame the doctor for not taking good impressions and the doctor blames the lab technician because the fit’s not right,” Dr. Lowe said. “A good dentist/technician relationship has to start with communication on all levels. It starts with each party letting the other one know what they need to get from that person to do their best work. And when there’s a problem, both sides have to take care of it regardless because we’re dealing with humans. Nothing is perfect.”

To really strengthen the relationship, it’s also a good idea to meet your lab technician in person, Grubb said. He encourages his clients to come to his lab for a tour so they can see and really understand what they do there. Clients always leave with a new understanding and an appreciation for the lab technician’s role. But although he pushes it on every client, only about 5 percent of them take him up on the offer. That 5 percent represents his most successful, most easy-to-work-with clients.

In an attempt to stay connected, he also puts together CE events, lunch and learns and even has a dentist on staff who talks with dental assistants about why communication is so important to successfully completing cases.

“It’s amazing the connection between coming to the CE, visiting the lab, opening up communication and a successful dentist,” Grubb said. “It’s amazing the connection, how they all link together.”

Working with a local lab is another great way to enhance communication, Grubb said. You can actually go there in person and talk about cases face-to-face, which is such a benefit to both you and the lab technician.

It’s not just you
Remember, poor communication doesn’t just cost you time and money; it costs the lab you’re working with and your patients. When communication is lacking, it can be frustrating for everyone involved.

To make the process smooth from the beginning, don’t take any short cuts, Dr. Lowe said. Give the lab technicians all the information they need to do their job, and don’t skip any steps along the way. This will only cost everyone time in the long run.

“The problem is time. Everybody is in a hurry. Everybody is trying to do too much too fast and I think there comes a time when expediency and efficiency and speed and quality start to separate,” Dr. Lowe said. “That’s different for everybody. You have to know your own limits. Not to say you shouldn’t be productive, but don’t take so many short cuts you end up spending more time to get it right.”

A team effort
You and your lab technician need each other to do your jobs. To get the best results for your patients, you have to put the time in to build this relationship. You have to know you can trust your lab to do quality work, and you need to give technicians the respect they deserve.

If you take the time to communicate and work on building a strong relationship, it will only make your cases more successful and your patients happier. And in the end, that makes you look good.

“I tell you, one of the best relationships we have is with our technicians,” Dr. Lowe said. “Patients don’t ask their friends what dental technician did their work. They ask what dentist did their work. The work the technician gives you has your name on it so it has to be good.”

Renee Knight is a senior editor for DPR. Contact her at rknight@advanstar.com.

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