One of the cornerstones of providing exquisite restorative results for our patients is a dental laboratory that can capture our vision for the patient, has the skill to execute that vision and is willing to work with us to develop the vision collaboratively. Over the years I have worked with many different ceramists, even originally my father who owned a crown and bridge lab his entire adult life. I got to hear lots of stories over the dinner table about the dentists he worked with, some of whom he was dear friends with and others who he blamed for his grey hair. Once I became a dentist I got to be on the other side and learn more about how special it is when this partnership works like a well oiled machine, and how frustrating it is when it doesn’t work.
I have also come to understand that like every relationship in life, they are developed, they never “just happen”. As I travel around and teach one of the most common questions I get asked is “What lab do you use?”. I’m happy to answer that question,as I am really incredibly fortunate to have a lab relationship that is everything I could hope for. I am also hesitant to answer the question as I know the amount of time and effort on both sides that went into creating the seamless, exquisite partnership I have with Gold Dust Dental lab. Upon reflection on how to best answer this question I decided to put together this series and that it had to have both points of view. I posed some questions, both to myself and to Rob Maatta CDT, owner and master ceramist at Gold Dust Dental Lab.
With an eye to technical success in the areas of fit, form, function and esthetics here are the first two questions:
- Lee, are there any key things you can suggest to dentists to improve the quality of their lab processed restorations?
Lee- The first thing that comes to mind is to be clear about what your expectations are and the process that goes into creating them. I think we would all like to get restorations back that drop onto the margins, are a perfect “snap” to floss and have just the right intensity of occlusal contacts in exactly the right places. Oh, and by the way, are a perfect esthetic match so all we have to do is mix cement. Does this happen in my practice? Yes, with increasing frequency. I attribute being able to get that level of expectation met consistently with a journey that included learning and collaboration. One of the most powerful things that I came into dentistry with was a knowledge of the lab process from working in my dad’s lab. I got to experience first hand how incredible it is that a ceramist can produce the results they can, with in true very little information to go on. I’d encourage every dentist to sit side by side at a lab bench, even for a few hours, and watch the process. You will gain an incredible understanding of what you need to provide your ceramist to enable them to produce exquisite results. We hold a great amount of the control on our side of the equation so improving everything from treatment planning to records taking is key. Records our how we most often communicate with the lab, so being meticulous about impressions, bite records and photography can not be stressed enough. This then makes me think about how we best collaborate. We don’t need the same records for every case, nor are we going to prep every case the same way. getting consistently fabulous results for me begins by collaborating with the lab in the treatment planning process to discuss every step of the execution and what the lab will need from me to do their best work. In that same conversation I get to share my concerns and expectations, and I expect the same in return.
- Rob, are there any key things you can suggest to dentists to improve the quality of their lab processed restorations?
Rob – Work with a lab that is committed to education and understands the challenges that you face as a clinician. It would be easy to sit at a bench and forget about the patient, their emotions and have ultimate respect for the challenges that clinicians face unless you were educated. We get to see restorations from 360 degrees, that are removable on individual dies on an articulator with no blood, saliva, soft tissue or perceived pain. It would be easy to be critical of prep design or a record that was missed if you worked exclusively in that environment. But we are intimately aware of the stress of patient care. Almost every month we are involved with our doctors and are educated with them at the Clinical Mastery Series. First hand we are involved in live patient and hands on education that ultimately creates a synergy of understanding. It also allows doctors to practice without the stress of patient care. Whether that is improved photography, bite records, occlusion training, implants or the vast variety of topics, its a commitment to learning that sets clinicians and labs apart. This to me is priceless in improving results.
Barry Polansky says
Hi Lee…A topic that is very close to me as you know. I have seen this issue from many sides.When Josh and I opened Niche Dental Studio 5 years ago…it was as if we had to develop a new “working” relationship…more of a functional relationship, rather than a father-son relationship. I like to think that developing that relationship made me a better dentist—and him a better technician.
Josh, being young and very focused on technical excellence, had to grow into relationship development with his outside clients. I would be lying if I said it was easy (as your father’s gray hairs have shown).
If have witnessed breakdowns on both sides—usually breakdowns in trust, appreciation and resposibility (hence the title of my blog TAOofDentistry.com).
If those words sound familiar–you know where I first learned them—applying them was the journey.
The dentist-technician partnership is a long-term relationship that makes life easier for everyone—and let’s not forget staff and patients.