There are a lot of dental labs out there...yours better be awesome. 3 Steps to choosing the right one...

You've just graduated from dental school and started working your first year out as an associate... Perhaps you've even moved to another city. Your contacts and experience are limited. Where do you send your first implant case, cosmetic case or occlusal guard?  If were anything like me, you defer the dentist you're working with, or you revert back to the lab you used in dental school. Honestly, I can tell you that my first several years I just blindly sent out cases to whoever my employer was using because it was easy. I had enough on my plate, and didn't even know where to start. I mean, they all should give me what I need...right?

Eventually, I learned that...no, they did not all give me what I wanted. . I then started using larger ( and cheaper ) labs like Glidewell for my implant cases. I soon learned that while they returned cases back at a "fair" quality, the communication and efficiency that I EXPECTED just was not there. I tried to speak to the technicians about specific issues I was having, and always ended up speaking to a different tech. Cases took weeks longer than expected because of the labs lack of communication. 

My BIGGEST annoyance with  labs occurred when my detailed instructions are completely ignored and the case is returned according to their  "default" specifications. I would state that I would want a "phone call" if the lab tech had questions about my case. All too often my case would be completed incorrectly, and without a phone call. So, to avoid embarrassment (having to call patient to reschedule, having to send cases back after they don't fit correctly and having cases fail), I recommend the steps to finding and communicating effectively with your new lab. Take the time to follow these instructions, because they will allow you to avoid the painful and frustrating learning curve most young dentists go through while learning how to find/use/communicate with a dental labs . 

1) Research

Before you graduate, poll you instructors (those actually IN private practice). Ask mentors and recent graduates A) Which labs they like, and which they don't and WHY? B) What specific types of cases have they used them for (often you'll find that different labs will outperform in speed/cost/quality for specific types of cases vs another lab)? Don't be afraid to have several different labs in your arsenal, and use them for specific types of cases that fit your needs. Labs would love to lock you down and have you automatically send every case over to them, but make them work for it and prove they can excel in each area AND meet your expectations. 

2) Face to Face Meeting - Communication

After you've got your 3 or 4 labs narrowed down. Make them show you what they can offer YOU. Set up a face to face meeting. Make them explain who you contact person is for big implant cases, and how they can help you problem solve staging and treatment planning of difficult cases. One often overlooked area by young dentists is the support and expertise that a experience lab contact can have when troubleshooting or problem solving a specific case. As a young dentist, we need all the support and advice we can get, and having a easy to reach and experienced lab contact will in INVALUABLE during your first several years. Get contact info for EACH person you'll be working with at the lab. I've now got my "fixed guys" and my "removable guys" cell numbers above my desk at work. They know to call me for any question they may have while working on one of my cases. I've learned that they actually need you to give the permission to contact you, give advice and recommendations and feedback; because they've probably been chewed out by older dentists that were appalled that a lab tech would have the nerve to call to discuss a case. They want to cater to your needs, want your business and do not want to offend you. Because of this they tend to try to simply please you vs. offer their insight and authentic feedback. Give them the permission to give you feedback and expert advice, ask them to call you often with case questions, and use them as a resource if you have a question. I communicate often and in depth. At my labs they know who i am, what I want and what I expect. Communicate, and I guarantee that your stress level and case quality will increase. 

Your lab contacts should be highly recommended and experts in their field ( fixed, implants, removable, etc). As a young dentist, you don't have the time, energy to get stuck with a new lab tech...it's not a good marriage. DEMAND that you work with the best...we need all the help we can get in those early stages of our careers. 

3) Keep Them Accountable

Monitor case quality/fees/speed and communication. These are the variables that should be monitored. Mid to smaller size labs that are in your areas may be able to expedite cases more easily and make special deliveries...which is very handy for "time sensitive" patients. Fees may be slightly higher than large mega labs, but you should make sure the don't fall too far out of line (no greater that 10 % of mega lab prices). Mega labs ( Glidewell/Microdent) are great for keeping cost low, and I do still use them for specific cases ( occlusal guards or example). I use them because they are fast (with these cases) and cheap, and the quality is indistinguishable from smaller labs. The thing to realize, is often small to mid size labs are shipping your cases ( bruxzir mllling, zirconica and implant frameworks) to the SAME milling center. So. you should periodically evaluate prices and hold your lab accountable them. Unless you are working with some famous ceramist on very specific ( and expensive ) cosmetic cases...all prices should be comparable. There is no need to be paying a premium for quality you expect. A good lab will deliver quality/communication/speed at a fair price. 

If communication or quality drops off with the lab you are using...call them. Speak to your contact and let them know what you're seeing and what your expectations are. If they don't follow through...find a new lab! As I mentioned in the title: "there are a ton of labs out there" and in general I bet the majority are doing a lot of things right. Find one that works for you...make and USE your contacts...leverage their expertise and advice and keep prices in line. 

In summary, I've made great contacts at my local labs. They are my go to for removable, implant and fixed cases. I have their cell numbers and they have mine. We speak on almost every case. Don't expect the know exactly what you want...tell them and work with them. It will save you so much dysfunction and dissatisfaction/frustration. You don't need those things in your career, especially in the beginning. I learned to use the larger labs for cases that require less communication. Occlusal guards from Glidewell have been fantastic...and come at a great price. 

I hope this helps. Keep learning and moving forward. Good luck!

~ Cole Brenny DDS