COMMUNICATING WITH THE DENTAL LABORATORY AP&T

Question 1

dental lab QA
(6)

Answer 1

 1.Current process and reporting
 2.Quality concerns
 3.New Q.A. assignments/responsibilities
 4.Student didactic education
 5.New forms and the student clinical Q.A.
reporting process
 6.Scheduled external dental lab educational
rotations and feedback

Question 2

SOD quality concerns
 Dentures:
 RPD frameworks:
 Fixed:

Answer 2

open occlusion, unsatisfactory
wax-up

Absent master cast tripod
lines; absence of specified undercuts

need the desired metal and porcelain
design from the C&B design form; need an
adjustable articulator for multiple units/FPD’s

Question 3

never use a — for an FPD or survey crown

Answer 3

quadrant impression

Question 4

SOD quality cocnerns
contract lab completions
 Dentures:
 RPD frameworks:
 Fixed:

Answer 4

bulky/thin (cameo) complete
dentures

over-finished, Rx not
followed; incorrect clasp placement/finishing

porous dies; over-contoured/thick
prosthetic margins; short metal margins;
damaged die preparation; broken/glued dies;
expensive reduction copings ($20 each)

Question 5

definition of the QA cycle

Answer 5

 Plan
 Do
 Check
 Act
 Q.A. is a combination of efforts among
educators, staff, and students

Question 6

new standards

Answer 6

 Students must routinely assess their own
progress toward overall and individual
competencies as they move through the
curriculum.
 CODA standard 2-23g calls for
“communicating and managing dental
laboratory procedures in support of patient
care.

Question 7

general ed concerns (5)

Answer 7

 Lack of programs in dental education
addressing the students’ technical knowledge
in performing and discussing dental lab
procedures
 Reduced dental lab technical exposure for
students
 Ineffective communication with the
commercial dental laboratory
 Proprietary interests and commercial biases
could set future laboratory and clinical
standards
 Denturism

Question 8

dentist/technician communication
(2)

Answer 8

 “The potential lack of understanding of
laboratory procedures as students translates
into poor communication with laboratory
technicians in practice.”
 Technical knowledge and its application are a
vital part of prosthodontic treatment planning
and communication-with both the patient
and technician!

Question 9

common concerns expressed by dental lab technicians (3)

Answer 9

 Lack of recognition by the dental team
 Lack of effective communication in the lab
prescription
 Lack of knowledge by the dentist about
technical procedures

Question 10

higher case rejection for d4 students (4)

Answer 10

 Pressure for students to get requirements
completed by graduation
 Stress from the National Board Examinations
 External rotations with no opportunity for lab
communication
 Not paying attention to detail and rushing

Question 11

new QA responsibilities

Answer 11

 Dr. Alison Louie-SOD Q.A. coordinator
 Dr. Gottman-Dental Laboratory dentist
designee/liaison
 Drs. Gottman, Deines, and Ball Q.A. lab cases

Question 12

objectives (8)

Answer 12

 Choose the right lab for your needs
 Meet the lab owner and staff
 Discover value-added laboratory benefits
 Communicate your needs
 Utilize the laboratory prescription completely
 Understand lab case turn-around times and
remake policy
 Review the fee schedule
 Understand payment policy

Question 13

lab QA/communication concerns of lab technicians (6)

Answer 13

 Lack of recognition by the dental team
 Lack of effective communication in the lab
prescription
 Lack of knowledge by the dentist of technical
procedures
 Lists of most common errors by student year
 Journal of Prosthodontics 22 (2013) 85-91
 “Lab Q.A. in the Department of Restorative
Dentistry at the Univ. of Illinois at Chicago,
College of Dentistry”

Question 14

lab choices
(6)

Answer 14

 Referrals from colleagues and specialists
 www.nadl.org National Association of Dental
Laboratories
 Dental laboratory publications: JDT, LMT
 State dental board
 ADA
 Cheapest option (worst choice)

Question 15

lab on site visit (8)

Answer 15

 Make an appointment with the owner
 Tour the facility(ies); technology and materials
used; CAD/CAM; 3D printing, AI?
 Talk with and observe the technical staff
 Ask who specifically will be doing your work
 Discover the number and type of CDT’s in that
lab
 Does the lab outsource? Where?
 Observe cleanliness and infection control
 Review the laboratory’s quality assurance
process-look at samples of their work!

Question 16

lab value added benefits (5)

Answer 16

 Custom shade determination service
 Continuing education offered when requested
 Consultation at your office, if necessary
 Remote consultative services: treatment
planning, material selections, technical
guidance
 Training provided for your support staff

Question 17

communicate your needs (6)

Answer 17

 Types of prosthetic restorative support you
need, i.e. Fixed, Removable, Acrylic, Implant;
CAD/CAM, 3D printing
 Shipping requirements
 Desired lab case turn-around time
 Technical support
 Materials available-specific information
 Continuing education

Question 18

utilizing lab work authorization (2)

Answer 18

 Fully communicate the desired result
 Use all types of communication tools, i.e.
writing, diagrams, photos, design casts,
shade sources/objects, verbal, electronic,
virtual

Question 19

lab work authorization contents (7)

Answer 19

 Name, age, gender, occupation, lifestyle
 Date of request
 Detailed description of the desired prosthesis
 Specific materials/chemical composition to be
used, i.e. metal, acrylic, ceramic, polymer
 Shade (number and specific guide)-diagram,
photo, former restoration
 Desired occlusion-accurate casts,
interocclusal record, articulator settings
 Diagnostic cast(s)-design and 3D waxing

Question 20

lab work authorization (4)

Answer 20

 Compose it yourself
 Reread the final draft and opt to have
someone else read it for clarity
 Present clear and concise instructions
 Submit neat/clean quality case components
to the laboratory

Question 21

turn around times (5)

Answer 21

 Inform the lab of the TAT you desire
 Will the lab’s TAT be consistent?
 Can the lab meet those times, at what cost to
you?
 Will the lab outsource any of your work?
 Who pays the shipping? Overnight or longer?

Question 22

remake policy (4)

Answer 22

 Review the laboratory’s quality assurance
process
 Inform the lab concerning your office Q.A.
process
 How will you both communicate if quality
concerns arise?
 What is the laboratory’s remake policy-
considering a lab error or a case submission
error ($$ responsibility)

Question 23

lab fee schedule (4)

Answer 23

 Understand the material options available for
each type of prosthesis
 Understand additional charges to a stated
basic fee, i.e. denture teeth, type of precious
metal, number of RPD clasps
 Reference the publication for fee
comparisons, Laboratory Management Today
www.lmtmag.com
 Consult with colleagues

Question 24

payment policy (5)

Answer 24

 What does the lab expect from its customers?
 Payment plans/options
 Credit policy, credit card use
 Late payment charges
 How will you incorporate laboratory charges
into your patient billing plan?

Question 25

report everything (2)

Answer 25

 Successful and unsuccessful prosthetic
results-Fixed and Removable
 Provide photos as well as descriptions

Question 26

private dental lab rotations
discontinued due to covid
(5)

Answer 26

 In the Spring semester third year dental students
are divided into groups.
 They have scheduled rotations in a private dental
lab.
 At the lab, small groups will rotate among the
various technical sections-C&B (metal, ceramics,
porcelain), Acrylic, RPD framework, CAD/CAM
 Student/technician communication will be
encouraged
 Feedback will be collected for future educational
development. Answer the 5 questions I give you