The Importance of Effective Communication Between the Dentist and Dental Lab

“Communication is the key to success in cosmetic dentistry/laboratory relations”⁵. To accurately fabricate dental restorations, effective communication needs to exist between the dental lab and the dentist to ultimately provide dental patients with the best dental care. The communication methods used by the dental lab to collaborate with the dentist is also a major factor that determines the success or failure of dental lab products.

“Prosthodontics is a discipline that requires a synergy between the dentist and dental technician in order to fabricate intraoral prostheses with acceptable fit, function and aesthetics,” reported by Berry et al.. Although restorative dentistry is first about restoring the patient’s oral health, and next the esthetic appearance; the patient’s growing demand for realistic esthetics and long-lasting restorations is challenging the industry to properly manufacture dental lab products that exhibit both attributes. Recreating esthetic details that mimic the patient’s natural teeth is crucial when “subtle details in texture, anatomy, and contours keep the ceramic restoration from looking contrived and can provide the element of ‘prefect imperfection’ that natural teeth exhibit”³. Precise design parameters, shade matching, and available tooth structures should all be effectively communicated by the clinician to the dental lab to achieve a highly esthetic restoration that will match the patient’s natural tooth contours and shades³.

The lab technician’s ability to match the exact shade to the patient’s teeth is a challenging aspect of communication; especially, when an increasing number of patients are demanding esthetically brilliant prostheses. Determining a precise shade (e.g., color, surface texture, shade characteristics) is first dependent on the clinician and must be effectively communicated to the lab technician. Exact shade communication is important because dental technicians are remotely located and usually never see the patient¹. In consonances with a study on color matching, Seal et al. reported “precise color communication is integral to the development of esthetic harmony and overall restorative success.” 

The communication methods used by the dental lab are major factors that influence the accuracy of dental lab products. With the development of software programs and web applications, dental labs can now use web content management systems (WCMS) to communicate to dental offices and manage laboratory cases at a faster and more accurate rate. As stated by Alshiddi, “Laboratory case management is a teamwork that should involve good communications between not only the dentist and the dental technician, but also other staff in the dental office (e.g., dental assistant and receptionist) and dental laboratory (e.g., laboratory owner, receptionist and delivery person)”⁵. When managing a high volume of dental lab cases, the lab must implement an effective content management system that will manage all of the dental cases coming from multiple forms of communication methods (e.g., hand-written lab authorization forms, telephone, email, electronic STL files, etc.). Equally important is the lab’s understanding of individual software requirements and design of the software that will essentially, if implicated correctly, improve communication and will ensure long term relationships between the dental office and dental laboratory⁵.

The dental laboratory must provide great customer service for dentists and their dental office personnel so all parties can work proficiently together. Providing excellent dental lab services will lead to satisfied clinicians and comfortable professional relationships between the clinician and dental technician/laboratory⁵. Collaborative technical advice on routine and complex dental cases is a very important service that dental laboratories should exceed at every time. The dental lab must have an effective logistic team to make sure dental cases are fabricated in time for the patient’s scheduled appointment.

Adequate skills of the dental laboratory and clinician along with collaborative teamwork through effective communication leads to high quality dental restorations. When problems arise from inaccurately fabricated prostheses, the patient will usually blame the dentist for the mishap. For this reason, it’s imperative dentists choose the best dental laboratory that can effectively communicate with their dental office to ensure satisfied patients every time and to ultimately provide better patient care. 

How Patients’ Decisions Influence Treatment Planning in Restorative Dentistry

As part of treatment planning, you as the dentist introduce options to your patients. After a relaxed conversation, a treatment plan is agreed upon between you and your dental patient. You use the best available research-based literature, clinical experience and patient opinions to guide your treatment decisions. As a dentist, you exercise substantial influence on which treatment method is chosen. Patients’ decisions can lead to less than ideal, though clinically adequate, treatment plans that give patient satisfaction over the long-term¹. Patients’ decisions are most affected by their relationship with you as their dentist over factors such as time, access, and cost¹. Health service providers may affect the decision-making process between you and your patient if specific treatments are favored or excluded on financial grounds. Kalsi and Hemmings recommends letters should be sent to patients explaining the “nature of all proposed options, including advantages and disadvantages, complications, success rates, biological and financial costs” and the consequences if no treatment is carried out¹.

Many psychological and social determinants influence patients’ values and decision-making when choosing a treatment plan in restorative dentistry. Frequently, a component of compromise between both parties in deemed acceptable even when clinical evidence indicates an alternative treatment to be more appropriate.

The best possible treatments should be based on the best available literature; however, the majority of treatment plans are greatly impacted by patients’ desires and expectations, which may not be based on sound knowledge¹. Patients’ wishes should be determined at the first treatment planning consultation to sort out whether they are realistic and possible within your own skill set, experience and knowledge¹. It is widely known that no dentist should perform any treatment that could harm a patient.

Time, number of appointments, use of anesthesia or sedative agents, pain and suffering are significant aspects to your patients’ decisions when selecting a treatment plan. You need to clarify biological and financial cost-benefit analyses to the patient¹. Also identify clinical factors, such as age, medical history and economics.

Patients seek dental treatment for three main reasons: comfort, aesthetics, and function. Patients are the real judge of whether their treatment is successful or not, so it is vital that they are pleased with their dental product¹. Their subjective assessments of a proposed treatment do not always correspond with their acceptance of evidence-based suggestions from clinical research literature. This assessment is contingent on the value patients accredit to a treatment. Aesthetic awareness can push patients to ask for destructive, biologically invasive work in situations where appearances could easily and equally be improved with lower risks of morbidity. For example, bleaching and bonding with veneers may “improve aesthetics with the same effect as full coverage crowns, with less tooth destruction and risk of dental pulp death and pain”¹.

Factors that affect patients’ decisions when deliberating treatment options:

•  Availability and access to care

•  Real cost per treatment option

•  Perceived value for money

•  Past dental history: positive or negative attitudes

•  Dentist’s confidence and competence

•  Patient’s confidence in dentist’s competence

•  Patient’s confidence in the treatment plan

•  Time and number of appointments

•  Perceived impact to quality of life

•  Pain and inconvenience associated with treatment¹

Interestingly, patients place more emphasis on your recommendations rather than on objective, evidence-based literature¹. If a dentist advocates a treatment, the patient is 2−21 times more likely to have it done¹. Comparatively, Kalsi and Hemmings found the endorsements made by evidence-based literature made no difference to a patient when choosing to proceed with a treatment. Confidence in your advice establishes the foundation of a professional relationship with the patient.

The significance of the dentist-patient relationship cannot be minimized, and a positive relationship is most likely to prompt a patient consenting for treatment. Patients put a lot of value on your recommendations. At the same time, patients want to play a collaborative role with you in the decision-making process. A treatment plan that is not evidence-based or approved with the patient runs the risk of losing a patient or, at worst, medico-legal action¹. However, treatment plans with an “element of compromise can be acceptable if, following full discussion with the patient, and taking into account all relevant factors, the benefits outweigh the disadvantages. This is the basis of informed consent”¹.

About the Company

Since 1991, Iverson Dental laboratories have provided dentists with high quality dental lab products and excellent dental lab services to ensure dental patients are completely satisfied with their restoration outcome. Iverson dental labs strongly believes in using high quality certified materials and authentic manufacturing components to fabricate their dental prosthetics given that material quality influences longevity of the restoration. Iverson values their skilled team of certified dental technicians because clinical evidence has shown adequate skills of the technician are important for the long-term success of a restoration. Iverson labs strive to be a great dental resource for dental professionals, offering training on CAD/CAM technologies in digital dentistry and advanced dental implant techniques at their cutting edge on-site operatory and training facility.

To find more helpful resources about restorative dentistry or to inquire about our dental lab services, please visit http://www.iversondental-labs.com or call us at (800) 334-2057.

References:

1. The influence of patients' decisions on treatment planning in restorative dentistry. (2013). Dental Update, 40, 698-710.

What Factors Influence Patient Satisfaction in Restorative Dentistry

According to “The Dental Practice-Based Research Network” (GPBRN), five general factors that influence dental patient satisfaction include:

1.  Technical quality of care

2.  Interpersonal factors

3.  Convenience

4.  Financial issues

5.  Office environment

Patient Satisfaction can influence a “patient’s likelihood of choosing a dentist, making and keeping appointments, and complying with dentists’ recommendations” ^[1]. Satisfaction can be considered a combination of the dissonance between the patients’ expectations and their experiences. Therefore, patient satisfaction is an important part of dental care that has the potential to impact restorative dentistry treatment outcomes ^[1].

Higher ratings of patient satisfaction in restorative dentistry occurs in cases with more experienced dentists because of greater proficiency, when the defective restoration is repaired rather than replaced, when restorative materials are a natural tooth color material rather than amalgam, and when the tooth is a premolar or an anterior tooth.

Effectively communicating the patient’s treatment plan and paying attention to concerns they may have are the most prominent components when patients are judging a dentist’s skill and quality of care. Whether the dentist recognizes their patient’s pain, talks over their fears, and aids in conquering their fears are very significant in terms of patient satisfaction. Patients deduce dental expertise from the dentist’s capacity to manage discomfort and provide a dental visit free from negative experiences.

It is vital to include patients in treatment decisions on medications, restorative material options and dental prosthetic procedures. Dentist’s who educate and involve their patients in treatment decisions, provide adequate time to comprehend facts and have their questions satisfactorily answered are more likely to have higher rates of satisfaction among their patients. Patients who are given more preparatory information have much better control of postoperative discomfort because their dentist effectively communicated what they should expect in terms of pain and how to control the discomfort.

Indeed, patients tend to use non-technical aspects of dental visits to appraise dentists’ technical capabilities. A dentist’s skills and quality of care are partially based on personal interactions with the dentist, the patient’s level of comfort, and post-treatment sensitivity. Steps can be taken to improve patient satisfaction by changing office policies or procedures, patient education and involvement, and/or the dentist’s interpersonal methods.

Dental practitioners should remember that human and psychological aspects of care are essential factors in determining the quality of care provided.

About the Company:

Since 1991, Iverson Dental laboratory has provided dentists with high quality dental lab products and excellent dental lab services to ensure their dental patients are completely satisfied with the restoration outcome. Iverson dental labs strive to be a great dental resource for dentists by offering training on digital dentistry and new dental implant techniques at their high-tech on-site operatory and training facility. Iverson dental labs strongly believes in using high quality certified materials and authentic manufacturing components to fabricate their dental prosthetics. Iverson Labs also strongly believes in having a knowledgeable team of certified dental technicians because clinical evidence has shown the skills of the clinician and technician are important for the long-term success of a restoration.

Reference:

1. Riley, J., Gordan, V., Rindal, D., Fellows, J., Qvist, V., Patel, S., . . . Gilbert, G. (n.d.). Components of patient satisfaction with a dental restorative visit. The Journal of the American Dental Association, 1002-1010.

The Importance of Finding a Dental Lab You Can Trust and Depend on for Quality Dental Lab Products and Services to Meet Patients’ High Expectations

In order to meet dental patients’ high expectations for long-lasting and highly esthetic dental restorations, its essential for dentists to find a dental laboratory they can trust and rely on for quality dental lab products to ultimately provide optimal patient care services. The long-term success of modern dental restorations depends on a number of factors that dentists must take into consideration when choosing the best dental laboratory to fabricate their patients’ dental prosthetics. Such factors include the lab’s ability to employ skilled dental lab technicians to adequately fabricate high quality dental lab products, and the lab’s ability to preserve the strength and esthetics of dental materials for restorations by executing proper lab techniques and procedures.

The success or failure of a dental restoration is also determined by how effective the dental lab’s communication methods are, prompting dentists to find a dental lab they can depend on for effective communication. Finding a dental lab that a dentist can trust to consistently deliver first-rate dental lab products and dental lab services can be taxing, but the alternative can lead to unsatisfied patients and be damaging to a dentist’s reputation.

Clinical evidence has shown the “skills of the clinician and technician are important for the long-term success of a restoration,” therefore dental laboratories must ensure their lab technicians have the skills and knowledge necessary to manufacture high quality prostheses on a consistent basis ^[1]. For instances, fabricating porcelain crowns and bridges is a highly sensitive technique and requires adequate skills of lab technicians because “minor laboratory faults may result in clinically unacceptable surface layers” ^[1]. One major fault is the formation of porosities that in turn may negatively affect the surface roughness, texture and shade of the restoration. Common reasons for the formation of porosities in dental porcelain as described by Rashid are “laboratory faults during condensation, in-appropriate powder/liquid mixing ratio and due to variations in firing time and temperature.”

The long-term clinical success of modern dental restorations greatly depends on “the physical properties of the material, the laboratory fabrication process, the laboratory fabrication technique and clinical procedures that may damage these brittle [ceramic] materials” ^[1]. The surface roughness and microstructure of dental materials, particularly dental ceramics, are also factors that influence the strength and long-term success of a restoration. During laboratory processes—such as powder compaction, process of forming, firing and shaping—can cause flaws in dental ceramics when the procedure is not performed correctly. Rashid explains during lab processes, flaws may become inherited in the surface and/or microstructure of dental ceramics that can compromise the strength and esthetics of a restoration. Surface roughness will “lead to a non-uniform stress distribution and concentrate locally an applied stress due to the shape differences in the surface layer… developed cracks cannot propagate randomly but occur or propagate at points with higher stress,” causing fractures at these points of high stress ^[1]. In other words, laboratory processes can influence the existence of micro cracks and residual stresses that affects the longevity of the material, and therefore should be executed competently with the correct dental lab procedures and techniques by capable lab techs.

Along with the ability to adequately manufacture ceramics and other dental materials with acceptable mechanical properties, the lab technician must also have the ability to recreate esthetic details that will match the patient’s natural tooth shape, texture and shade characteristics. Dr. Markus Blatz, restorative dentistry’s leading researcher at the University of Pennsylvania School of Dental Medicine, states the goal of restorative intervention is “to mimic nature as closely as possible” and the dental materials used should “depend on the patient’s needs” ^[6]. Recreating esthetic details that mimic the patient’s natural teeth is crucial when “subtle details in texture, anatomy, and contours keep the ceramic restoration from looking contrived and can provide the element of ‘prefect imperfection’ that natural teeth exhibit” ^[4]. In The Penn Dental Journal for the University of Pennylvania School of Dental Medicine, Dr. Blatz explains how he relies on the artistic skills of his dental technicians to first plan and design the substructures using CAD/CAM systems, and then build “the individual teeth by hand and applying the layers of ceramic on top of the copings and frameworks” ^[7]. He further adds, “Despite all technical advancements, machines are not able to recreate the intricate and subtle esthetic features of a natural tooth. That’s why [the lab technician’s] artistic expertise is so important" ^[7].

Restorative dentistry also requires effective communication between the dental lab and dental practice to achieve the restorative goals set by the patient and dentist. With the development of software programs and effective web applications, dental labs can now use web content management systems (WCMS) to communicate to the dental office and manage laboratory cases at a faster and more accurate rate. As stated by Alshiddi, “Laboratory case management is a teamwork that should involve good communications between not only the dentist and the dental technician, but also other staff in the dental office (e.g., dental assistant and receptionist) and dental laboratory (e.g., laboratory owner, receptionist and delivery person)” ^[2]. When managing a large number of dental lab cases, the lab must implement an effective content management system that will manage all of the dental cases coming from multiple forms of communication methods (e.g., hand-written lab authorization forms, telephone, email, photographs, electronic STL files, etc.). Equally important is the lab’s understanding of individual software requirements and design of the software that will essentially, if implicated correctly, improve communication and will ensure long term relationships between the dental office and dental laboratory ^[2].

Providing excellent dental lab services will lead to “well-designed prostheses, satisfied clinician and comfortable professional relationship between the clinician and dental technician/laboratory” ^[2]. The dental laboratory must provide great customer service for dentists and their dental office personnel, so all parties can work effectively together in the interest of the patient’s oral health. Collaborative technical advice on routine or complex dental cases is a very important service that dental laboratories should exceed at every time. The lab needs to have a strong management team to implement and oversee quality control processes on every dental case. They must also have an effective logistic team to ensure dental cases are fabricated and delivered in time for the patient’s scheduled appointment. Offering in-house custom shade appointments should be available for doctors and their patients, making sure the lab facility is up to professional standards in appearance and services they provide. 

As stated in General Dental Council’s (GDC) policy document Principles of dental team working, “members of the dental team will work effectively together” and members have to “communicate clearly and effectively with other team members and colleagues in the interest of patients” ^[3]. Given these points, choose a dental lab that employs a knowledgeable team of certified dental technicians that can consistently fabricate high quality dental lab products. Also, finding a lab that can effectively communicate with the dentist and dental office personnel is essential for the overall success of a dental practice.

About the Company

Since 1991, Iverson Dental laboratories has provided dentists with high quality dental lab products and excellent dental lab services to ensure dental patients are completely satisfied with their restorative outcome. Iverson dental labs offer training on digital dentistry and new dental implant techniques at their high-tech operatory and training facility. Iverson dental labs strongly believes in using high quality certified materials and authentic manufacturing components to fabricate their dental restorations. Iverson also strongly believes in having a dedicated, knowledgeable team of certified dental technicians because clinical evidence has shown the skills of the lab technician are critical for the long-term success of a restoration. They serve dentists from all over North America with a strong following in Pennsylvania (PA), Texas (TX), and California (CA), where they are leading the way in providing professional dental lab services and products to ultimately improve patient care in restorative dentistry.

Reference:

1. Rashid, H. (n.d.). The effect of surface roughness on ceramics used in dentistry: A review of literature. European Journal of Dentistry Eur J Dent, 571-571.

2. Alshiddi, I. Communication Between Dental Office and Dental Laboratory: From Paper-based to Web-based. Pakistan Oral & Dental Journal, Vol. 34 Issue 3, p555.

3. Berry, J., Nesbit, M., Saberi, S., & Petridis, H. (2014). Communication methods and production techniques in fixed prosthesis fabrication: A UK based survey. Part 1: Communication methods. BDJ Br Dent J.

4. Weston, J., & Haupt, E. (n.d.). Creating Aesthetic Success Through Proper Clinician and Laboratory Technical Communication. Dental Clinics of North America, 371-382.

5. Miyazaki, T., Nakamura, T., Matsumura, H., Ban, S., & Kobayashi, T. (n.d.). Current status of zirconia restoration. Journal of Prosthodontic Research, 236-261.

6. Blatz, M. (2013, January 1). Prosthetic parameters and materials for anterior implant esthetics. Lecture. https://www.for.org/en/video-insights/markus-blatz-prosthetic-parameters-and-materials-anterior-implant-esthetics?rate=KDjDad61ETC0oRsYOyMxaye7jTkb3qvyTEpMruuj9qM

7. Bonett, J. (2009). Bringing Da Vinci to Dentistry. Penn Dental Journal, 5(2), 2-5. Retrieved August 31, 2015, from http://www.dental.upenn.edu/pdf/penn-dental-journal/pdj_spring09.pdf

The Importance of Effective Communication Between the Dental Lab and Dentist to Ultimately Provide Better Patient Care

“Communication is the key to success in cosmetic dentistry/laboratory relations” ^[3]. The importance of good communication has been highlighted by a number of studies ^[3]. Effective communication between the dentist and the dental laboratory is critical when fabricating well-designed, high quality dental restorations to ultimately provide patients with the best dental care. The effectiveness of the communication methods used by the dental lab to collaborate with the dental office is also a major factor that determines the success or failure of dental lab products.

As reported by Berry et al., “prosthodontics is a discipline that requires a synergy between the dentist and dental technician in order to fabricate intraoral prostheses with acceptable fit, function and aesthetics.” Although restorative dentistry is first about restoring the teeth’s function and oral health of the patient, and next the esthetic appearance; the patient’s growing demand for realistic esthetics and long-lasting restorations is challenging the industry to meet these high expectations by producing dental products that exhibit both attributes. Recreating esthetic details that mimic the patient’s natural teeth is crucial when “subtle details in texture, anatomy, and contours keep the ceramic restoration from looking contrived and can provide the element of ‘prefect imperfection’ that natural teeth exhibit” ^[4]. Precise design parameters, shade matching, and available tooth structures should all be decided and effectively communicated by the clinician to the dental lab in order to successfully achieve a highly esthetic restoration that will match the patient’s natural tooth contours and shades ^[4].

The lab technician’s ability to transfer exact shade matching, along with the ability of the clinician to communicate accurate tooth shades, is a challenging aspect of communication; especially, when an increasing number of patients are demanding esthetically brilliant prostheses. Determining a precise shade (e.g., color, surface texture, shade characteristics) is first dependent on the clinician and must be effectively communicated to the lab technician in order for the lab tech to achieve exact shade matching for the final restoration. Exact shade communication is important between the technician and dentist because dental techs are remotely located and usually never see the patient ^[1].  In consonances with a study on color matching, Seal et al. reported, “precise color communication is integral to the development of esthetic harmony and overall restorative success.” 

The methods used by the dental lab to communicate with the dental practice are also major factors that influence the accuracy of dental lab products. With the development of software programs and effective web applications, dental labs can now use web content management systems (WCMS) to communicate to the dental office and manage laboratory cases at a faster and more accurate rate. As stated by Alshiddi, “Laboratory case management is a teamwork that should involve good communications between not only the dentist and the dental technician, but also other staff in the dental office (e.g., dental assistant and receptionist) and dental laboratory (e.g., laboratory owner, receptionist and delivery person)” ^[3]. When managing a large number of dental lab cases, the lab must implement an effective content management system that will manage all of the dental cases coming from multiple forms of communication methods (e.g., hand-written lab authorization forms, telephone, email, electronic STL files, etc.). Equally important is the lab’s understanding of individual software requirements and design of the software that will essentially, if implicated correctly, improve communication and will ensure long term relationships between the dental office and dental laboratory ^[3].

The dental laboratory must provide great customer service for dentists and their dental office personnel so all parties can work together proficiently. Providing excellent dental lab services will lead to satisfied clinicians and comfortable professional relationships between the clinician and dental technician/laboratory ^[3]. Collaborative technical advice on routine and complex dental cases is a very important service that dental laboratories should exceed at every time. The dental lab must have an effective logistic team to make sure dental cases are fabricated in time for the patient’s scheduled appointment, also ensuring patients are satisfied with their dental care services.

“By far my happiest [Dentists] with the happiest patients are the ones that communicate with the laboratory and view it as part of a team effort to achieve the right result for the patient,” stated one dental technician in a study on the communication methods used between the lab and dentist ^[1].

Along with adequate skills of the dental laboratory and clinician, good teamwork through effective communication between the dentist and dental lab leads to high quality dental restorations with excellent fit, function and esthetics. When problems arise from inaccurately fabricated prostheses, the patient will usually blame the dentist/dental office for the mishap. For this reason, its imperative dentists choose the best dental laboratory that can effectively communicate with their dental office to ensure satisfied patients every time and to ultimately provide better patient care.

About the Company:

Since 1991, Iverson Dental laboratory has provided dentists with high quality dental lab products and excellent dental lab services to ensure their dental patients are completely satisfied with the restoration outcome. Iverson dental labs strives to be a great dental resource for dentists by offering training on digital dentistry and new dental implant techniques at their high-tech operatory and training facility. Iverson dental labs strongly believes in using high quality certified materials and authentic manufacturing components to fabricate their dental restorations. Iverson also strongly believes in having a knowledgeable team of certified dental technicians because clinical evidence has shown the “skills of the clinician and technician are important for the long-term success of a restoration” ^[1].

Reference:

1. Berry, J., Nesbit, M., Saberi, S., & Petridis, H. (2014). Communication methods and production techniques in fixed prosthesis fabrication: A UK based survey. Part 1: Communication methods. BDJ Br Dent J.

2. Afsharzand, Z., Rashedi, B., & Petropoulos, V. (n.d.). Communication Between the Dental Laboratory Technician and Dentist: Work Authorization for Fixed Partial Dentures. J Prosthodontics Journal of Prosthodontics, 123-128.

3. Weston, J., & Haupt, E. (n.d.). Creating Aesthetic Success Through Proper Clinician and Laboratory Technical Communication. Dental Clinics of North America, 371-382.

4. Seal, M., Talukdar, P., Srivastav, V., & Pendharkar, K. (2014). Colour Matching: A Review of Conventional and Contemporary Dental Colour Matching Systems. International Journal of Oral Care and Research, 2(5), 47-53.