Editors and writers. Architects and engineers. Directors and actors. Dentists and dental lab technicians. For any professional creative team, communication is the key to success. And conversely, poor communication almost always guarantees failure.
Clinicians and technicians have an array of cool gadgets and advanced technologies that not only simplify the transfer of information between the practice and the lab, but enhance its quality. That said, there remain some tried and true chairside basics that continue to be “musts” for the indirect restorative process.
Dentalcompare asked some dental laboratories to sound off about common inadequacies they see in what the dentists provide for cases. We share these in the spirit in which they were offered—teamwork and collaboration and the ultimate goal of successful clinical outcomes for patients.
What are the top three ways your dentist customers could improve the lab/doctor communication process? In other words, what are the most common obstacles doctors create that lead to less-than-perfect cases?
Nelson Rego, CDT, Co-owner, Smile Designs by Rego, Santa Fe Springs, California
1. Incomplete lab slips that lack pertinent information--for example shade, type of material, will the restoration be bonded or cemented, what if any restorations are planned for the future? Often doctors will send the case and ask for a shade; then they will send it back saying that the patient was bleaching and that the crown is now too dark since they of course matched the pre bleach shade
2. Poor impressions that lack enough detail in both the opposing or adjacent teeth. If the opposing or contact teeth are slightly off, then the chances of seating the case quickly are diminished.
3. Prep designs. Typically, dentists under-reduce or over-reduce because many do not have a clear understanding both the requirements for materials and the orthodontic alignment of teeth and what has to happen in order to get teeth to look natural.
Michael DiTolla, DDS, FAGD, Director of Clinical Education & Research, Glidewell Laboratories, Newport Beach, Calif.
The top 3 ways dentists could communicate better with our laboratory:
1) Better Preps and Impressions— In private practice it pays to be efficient at crown and bridge procedures. Unfortunately, the other side of that coin is a loss of precision in preparations and impressions. I spent 5 years trying to come up with a system that allows efficiency and ensures precision, and I came up with the Reverse Preparation Technique. The video can be viewed at www.glidewell-lab.com or you can order a dvd that will be sent to you. When used in conjunction with the 2 Cord Impression Technique and the Rapid Anesthesia Technique, there is no reason you can’t be fast and precise, unless you simply choose to be lazy.
2) Digital Photographs— Taking dental photographs has always been difficult, time-consuming and expensive. That all changed with the advent of digital photography. As soon as you take a digital picture today, you can glance at the back of the camera and confirm it is acceptable. Of course you no longer have to send the film out to have it developed, you simply plug the camera or memory card into your computer and email the picture to us. Trust me, if you can’t do it, your staff will master it in about a week. What are the chances that anterior restorations will match adjacent natural teeth without a photograph? It’s a guessing game at best…
3) Digital Shade Taking— It doesn’t get much easier than this. You put the tip of the wand on the tooth, pull the trigger and you always get the right shade. Always. All you have to remember to do is take the shade at the very beginning of the appointment before the tooth gets dehydrated. I have used all of the systems and my favorite is the Easy Shade from Vita. It is the easiest system to use by far and takes Vita Classic shades and Vita 3D shades. I simply don’t understand dentists who won’t spend a few thousand dollars to guarantee they never miss a shade again.
Paul DiCicco, Sun Dental Labs, Clearwater, Fl.
Picking only three issues is a difficult proposition. As with all labs, we daily face the challenge of communication problems ranging from poor impressions to missing or inadequate bites and improperly completed prescriptions. We have just printed a form which addresses these issues to be sent to all our accounts. Here it is:
WHY YOUR CASE IS NOT THERE?
"In order to best serve our customers SUN DENTAL LABS has compiled a list of reasons why most cases are delayed.
All information on our websites and printed literature states that we do all procedures based on 7 working days in the lab; the exception is Procera crowns which are 10 to 12 working days in the lab.
Based on your location and using our pre-paid labels your cases will arrive in 2 days. When your case is completed we will also ship it to you with 2 days air. Not counting weekends that would be a total of 11 working days, if finished earlier it will ship right then. We do not rush cases.
Your case will be delayed:
1. If your case arrived with an incomplete script or no script at all.
2. If the script is a very light copy, or the handwriting is not legible.
3. If the script is present but does not properly identify which of your multiple offices it belongs to.
4. If no tooth shade or tissue color is specified on the script.
5. If two models arrived without the necessary bite needed to set up the case.
6. If a call is not returned by the doctor to clarify an issue with the case.
7. If the script belongs to another lab and sent to us by mistake.
8. If materials are not specified by name, example using the word acrylic when you mean SUNFLEX ® which is nylon.
9. If poured models arrive without a base, especially a lower it’s usually broken in half.
10. If alginate impressions arrive and you expect us to pour them for you.
11. If models and articulators are not properly wrapped in bubble wrap or some other packing material. More than likely we will have broken stone teeth and model damage.
12. If shipping companies loses or delay delivering your cases as scheduled.
13. If after all the above was perfectly done it may very well be our fault."