Position Statement

Dental Laboratory/Dentist Relationship

Position Statement of the American College of Prosthodontists
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Dental laboratories work in tandem with licensed dentists to produce dental prostheses such as removable complete and partial dentures, crowns, bridges, orthodontic appliances, or other dental restorations such as implant crowns. The dental laboratory follows the dentist’s prescription for the dental prosthesis to be produced by using an impression (mold) or digital scan of the patient’s teeth provided by the dentist. Unlike a pharmacy, where prescriptions are “filled” with medications that are shipped to the pharmacy, dental laboratories fabricate each patient’s prosthesis prescription using industry-specific materials.¹ The creation of these products begins at diagnosis, when the dentist determines a restoration is necessary for the patient.

Dentists should only send quality impressions, casts, or scans to the dental laboratory for the fabrication of any prosthesis. Prescription forms must be complete to allow the laboratory technician to accurately fabricate the prosthesis to the desires of the dentist. The prescription form must include the name and signature of the dentist, contact information of the dentist, name of the patient, and type of prosthesis, as well as clear instructions of all of components of the prosthesis. These components include, but are not limited to type of materials desired, desired occlusal contacts in centric occlusion and all excursive movements, types of clasps, attachments, esthetic characteristics, and other pertinent items.

Dental laboratories should contact the dentist when the directions are not clear or are inappropriate for the desired prosthesis. Dental laboratories should include a sticker certificate authenticating the materials used in the fabrication of all prostheses in the box returned to the dentist. Since dental prostheses are medical devices, information ensuring safety, such as material, composition, and manufacturer, should be included.²

Dental laboratories should not trans-ship (outsource) any work without the expressed consent of the dentist. Dental laboratories should adhere to strict infection control protocols and not accept work from dentists who do not follow accepted disinfection procedures.

Dentistry has seen a proliferation of new technology and materials. As a result, dentists now more than ever rely upon the skills of a qualified dental technician to assist with material selection. However, it is the dentists’ responsibility to prescribe appropriate materials and each patient’s specific needs.³ In a 2009 American Dental Association member survey, nearly 65% of dentists responded that they believe dental technicians and laboratories are regulated in their state. This is not the case. In fact, only four states in the U.S. require either certification or continuing education.⁴ It is important for the dentist to have complete trust and confidence in their technicians’ skills and knowledge. Accurate communication between the dentist and laboratory technician is necessary to successfully fulfill both their and the patients’ expectations.

References

1. National Association of Dental Laboratories: Standards. Tallahassee, FL, NADL. Available online at http://dentallabs.org/restoration-standards/. Accessed June 1, 2015.

2. U.S. Food and Drug Administration: Medical devices. Silver Spring, MD, FDA. Available online at http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm#3. Accessed June 1, 2015.

3. Christensen GJ, Yancey W: Dental laboratory technology in crisis: The challenges facing the industry. J Am Dent Assoc 2005;136:653-655.

4. National Association of Dental Laboratories: State regulation. Tallahassee, FL, NADL. Available online at http://dentallabs.org/state-regulation/. Accessed June 1, 2015.