Five (5) CRITICAL questions you MUST ask you laboratory!
1. “Do you use cutting-edge, PROVEN ADA-approved materials?”
This is important in that you want to make sure all materials the laboratory uses are manufactured by reputable companies. “Copy Cat” alloys are simply NOT the same. Typically, the biggest discrepancy is in long-term recall studies in a DENTAL application. So, how can you tell? In most cases…PRICE! You get what you pay for. However, if your laboratory does offer a reduced fee alloy simply ask for the composition and the manufacturer. Easily attained and provided by the lab. In addition, to ensure you are getting quality alloy, request the IdentAlloy®sticker from the manufacturer to be applied to all the invoices to certify what was used on the case.
What about the “all-ceramic” market? In the case of brand name crowns, such as the many different zirconia crowns on the market, you want to know if the lab is an authorized lab for that product and if they are using genuine material for that product. For example, is that a genuine e.max, Procera or Lava crown, or is it an imitation zirconia crown that costs a fraction of the price but is being passed off as the real thing? If it is a other brand…what is it? It actually may be just as good, if not better…simply research it.
2. “Do you use AUTHENTIC Implant manufacturer components?”
As with alloy, it is crucial that genuine implant manufacturer parts are used on your restorations, unless you request otherwise. There are many copycat implant manufacturers on the market today. Some make decent parts, while others are noticeably inferior. If you choose to use imitation parts, that is your prerogative. But if you ask for a genuine Nobel Biocare™ bridge and the laboratory uses a knockoff or mills their own that is a serious offense. The implant manufacturer’s warranty is voided, and you will be responsible for full charge on the remake. If the implant fails, the surgeon or periodontist will be responsible for the new implant. It is not uncommon for labs to use imitation components and pass them off as genuine. Just as you might question the ethics and reliability of a competing dentist who charges one-third the fee of every other dentist in the area, you must question how a lab can offer any implant restoration at such a low cost. However, don’t be fooled by a competitive, accepted fee. SOME labs will also utilize off-market components and charge FULL price! What to be certain? Simply contact your Implant representative. They will be able to tell you if the lab your utilizing is ACTUALLY using Authentic implant components.
3. “How do you perform quality control checks on your work?”
How does a laboratory make sure you are getting an optimal quality restoration? AND how can you be certain their quality meets your standards. There are some RED FLAGS (aside from simply trying a few cases.) If the turnaround time is very fast, you must consider what it takes to make a single porcelain-fused-to-metal (PFM) crown: The models need to be poured, “Pindexed” (or equal system), and counter models poured and mounted. The dies must be trimmed, die spacer applied, then waxed to correct contour. A sprue must be added, then placed on a base. Since it makes more sense to group wax-ups in a casting ring, a technician will wax more than one case and invest them all for overnight burnout. Is there someone who is in charge of quality control on these wax-ups to make sure that the wax-up is correct? The ring will be cast, divested, and finished. Is there someone who makes sure that the coping is made correctly to the exact specifications and desired alloy? The coping is cut back and opaqued. Finally the ceramist will apply the porcelain. A final quality control check is also required. If something needs to be adjusted, fixed, or remade, an extra day is more than helpful. An average lab will take at least seven days to do this work, not including the pickup. If a lab is taking three to five days for a single PFM, when does the quality control happen? How is the work being performed? Does the lab have full-time employees, or subcontractors who come in after hours and knock out a few units? Is the work performed at the lab? Find out how many technicians work at the lab, and ask if they all work full time. A consistent team of technicians supplies a consistent quality of work. If the lab allows after-hour technicians to come in after their workday at another lab to do a few units, consistency and quality will suffer. Furthermore, I encourage you to ask for the actual SOP (Standard Operating Procedure) for quality control. Is there a process of certification? Ask questions! You can view our Gardali-CERTIFIED™ SOP here!
4. “Do you send your work offshore?”
FACT: Some laboratories send their work to China, Korea, India, the Philippines, Mexico, Costa Rica, or any other country with lower labor and production costs. Sadly at times, this is practiced without telling the dentist. In addition, some of these countries and laboratories do not have the FDA or ADA compliance laws that we do to ensure that approved materials are used. Ask yourself how can a crown that contains palladium, gold, or silver DENTAL alloy, ADA-approved materials, porcelain, and that is made with quality craftsmanship cost less than $150? Even If the PFM is a NP crown and under $99.00, this may be a RED FLAG that the restoration is being done offshore. Turn around time is another indicator. Any single unit PFM taking longer than 7-8 LAB days is another RED FLAG! Many labs do not tell you they are sending the work overseas; they just pass it off as their own. Again, this can easily be verified. If the lab is local stop by and ask to see your cases. If NOT, call the lab and ask them to take a photo of your cases and send it to you immediately. All can be done and your lab will be glad to verify their work. HOWEVER, in some cases your practice may have limitations on what you can pay for a crown. For example a practice that accepts low-fee insurances simply can NOT pay more than $79.00 for a single unit, PFM NP crown. It is simply not feasible. In that case find a reputable lab that issues full-disclosure of material composition and vendors utilized AND where the crown is fabricated. YES…you can find safe, well crafted work from offshore providers.
5. “May I inspect your lab AND what is the culture of your laboratory?”
Ask, and then do it! Meet the lab owner and the quality control folks. Meet the office staff. Take a tour of the lab. Is it clean? If this is a quality-oriented lab, then the facility should follow suit. Why would you accept a dirty, pumice-covered, disheveled mess of a dental lab instead of a professional-looking establishment? You should examine the work pans and look at the work coming in and going out. Are the pans covered in plaster and the models and articulators sloppy and dirty? Do the impressions look like the kind you would send? Are the work desks neat? Do the technicians take care of the equipment and respect their tools? Take a look and see if they stock genuine parts. Ask to see all the pans. Look for a wall or shelf that has many empty pans with prescriptions in them. Ask why they are empty. Chances are the work has been sent offshore to be completed by another lab.
Plenty can be learned by a simple visit!
Are you interested in utilizing a laboratory that meets these demands? Simply click here for a Doctor Resource Kit! Everything & anything you would want to know is included.
Thank you in advance Doctor,