A positive, successful relationship requires communication

by Anita Jupp & Nancy McNutt

A positive life is built upon positive relationships with partners, children, friends and business associates. Our relationships, good or bad, are dependent upon many factors:

* How we communicate with others

* Understanding people’s needs and what is important to them

* Realizing that people are all different and that’s ok

* Having mutual respect

* Being honest about what you want, what you need and what you do not want

* Realizing that it’s ok to disagree

* Having guidelines and protocols

* Expectations of others

Business relationships are dependent on the same factors, the most important one being communication.

Running a successful dental practice can’t be done alone by the dentist. It takes teamwork to achieve success in dentistry and your dental lab must be considered a part of your team. Dental practices must work closely with dental labs to ensure positive treatment results for patients. The relationship between the dental practice and the dental lab must be positive for best results.

However, in many cases, there is tension between the practice and the lab.

The dental practice’s perspective:

* The lab was late sending back the case

* The lab lost the case

* The lab did not follow the prescription and now the patient doesn’t like the shape of their teeth

* The lab did the shade wrong and it wasn’t what was asked for

* The case does not fit properly because of the lab

* The material the lab used was defective

The dental lab’s perspective:

* The practice sent a bad impression

* The models from the dental practice were too poor

* The practice was too late calling us for pick up

* The dentist’s handwriting was illegible

* The time required was totally unrealistic

* The lab had to start all over because there was not enough detail on the prescription

So how do we deal with the problems between practice and lab? We COMMUNICATE!

You will never find a perfect dental lab or a perfect dental office. Too many dentists change from lab to lab searching for the ideal. Sadly, they may have had it in the first place if they had just communicated their concerns and needs to the lab. On the other hand, dental labs sometimes complain about dentists and say, “who cares if they go to another lab.” The dental lab should most definitely care. Dentists talk to their peers. Communication in this relationship must go both ways.

Where do you start as a dental office? Your first priority should be to have a meeting with someone from the lab to find out about all their services:

* Delivery requirements and policies.

* Do they have a reliable delivery and pickup service?

* Do they have a reliable delivery and pickup service?

* How does the lab communicate with you related to new products and services? Are they willing to have your team come into the lab to perfect the way they pour models, make mouth guards, etc.?

* Does the lab have the patients come to their lab for shading or do they come to you?

* Have the lab specifically list their detailed requirements from a dental office

* What are the lab fees?

* Is the lab easy to communicate with? Do they promptly return phone calls, etc.?

Top tips for working with a dental lab1

Labs also have communication requirements from dentists to help ensure a positive relationship between the two. Try to work with your lab in the following ways:

Send study models of a case in to the lab first if you are not sure the lab can do what you had in mind. A follow up telephone call will often result in the lab saying they cannot fabricate the case as you had suggested, but a better option may be available.

Photographs! Visit a good lab and you will see computer monitors everywhere. They are not for technicians to surf the internet but are for your photos. A photograph can save you 1000 words on your prescriptions.

If your laboratory calls you for a new impression they are not questioning your clinical skills. They are trying to save you an embarrassing appointment with your patient when a restoration will not fit. Remember, labs do not want to remake work either. Therefore when the lab calls about an impression or a bite, they usually see signs of a remake in the future. Encourage your lab to call you if there are any questions at all. A quick telephone call can save you valuable chairtime down the road.

Triple trays should only be used for single units. Manufacturers may tell you a different story, but for posterior bridges these types of trays need to be avoided. With the bending of the tray, the lack of an opposing quadrant to verify the bite, numbers show these types of trays for multi-unit cases result in a much higher remake percentage. The amount of impression material you save with a triple tray will not cover the lost chair time for a remake.

Labs know that when there is trouble, the dentist will call the lab right away. On the flip side, when a difficult case goes in without a hitch call the lab, or send post-op photos on occasion. Labs can learn from their mistakes as well as successes.

A good lab will use the best materials available. For doctors providing labs with impressions, be aware that not all impression materials, trays, and bite registration materials are equal.

Metal trays are better than plastic ones. Rigid plastic are better than ones with any sort of flexibility. Even perforated trays should be layered with tray adhesive.

Give your lab enough time to complete its work. Try not to push labs on their turnaround times if it is not necessary. Obviously there are times when a case needs to be rushed, and when this happens always pre-book cases with your lab. The turnaround times in labs are not arbitrary; they are set to a time-frame that the lab is comfortable it can provide the best quality in the amount of time afforded.

Loyalty encourages positive relationships. If you have received excellent work from your lab and they call saying they have dropped and chipped a model and need another one, stop and ask yourself if a model has ever been dropped in your office. Do not let honest mistakes hurt your relationship with a lab you have had many successes with.

Working with a lab: what dentists want

It is imperative that the dentist / lab relationship is a positive working relationship. To create a positive atmosphere, dentists and labs are encouraged to work together in the following ways:

* The lab should always provide quality workmanship and have pride in their work

* It is necessary that the lab understands that the dentist wants his cases back at least a day before the insert appointment. It is also necessary that the dentist understands that labs have set time frames for specific work and will work with the lab to ensure all cases are returned promptly. Communication is key here. A quality, professional lab should always provide a schedule of ‘minimum time required’ to complete specific cases.

* The business team wants a lab that clearly writes first and last names on the lab bills and understands the importance of this. The business team also appreciates two copies of a lab bill; one for the insurance company and one for the practice’s book keeping records.

* The practice wants a lab that is always open to answering all questions
and also accepts calls from the dentist.

* The practice always requires a list of fees for different procedures.

Practices prefer labs that offer a complete guarantee on their materials for a minimum of 1 year and up to 2 years. Dentists and practices appreciate labs that offer seminars and distributes information such as newsletters or new materials available. A lab that provides educational pamphlets to the dental office helps to increase case acceptance, which in turn increases their own production. Continuing education and knowledge is vital to everyone’s success in dentistry. In addition, an excellent lab opens its doors and invites the dental team in to see and understand the procedures and time requirements of a lab.

A dentist appreciates a lab that provides ‘no fee’ delivery and pick up of their cases. A dentist always appreciates prompt pick-up too.

An organized lab has detailed lab prescription forms that indicate specifics. For example — porcelain margins or metal margins, porcelain occlusion or metal occlusion, what type of contact is needed between the crown and adjacent tooth, the pontic design, etc. The form should offer a diagram to allow for more detail. Better results are achieved with more information. This leaves little room for error in the interpretation of the needs of the dentist.

With a great dentist/lab relationship, the patient wins, the dentist wins and the lab wins!

Both parties must work at building a relationship. Practices should think of the dental lab as part of its extended team. If something is not working, then get on the phone and discuss it and work it out. Loyalty and mutual respect are important in any business relationship. Together you can offer your patients the very best aesthetics, materials and customer service with the combined professional services. Happy clients always come back.


1. Ian Atkins, Classic Dental Labs, Toronto, Ontario.

Anita Jupp and Nancy McNutt are practice coaches and speakers with the ADEI: Advanced Dental Education Institute in Canada (www.learndental.com). Together they bring more than 50 years of dental experience to the table and they have helped thousands of dental professionals to reach their full practice potential.