Dental Labs in China: How Much Do You Really Know?
Dentists: How Much Do You Really Know about Dental Labs?
When lead was found in dental crowns made in China, the National Association of Dental Laboratories - the public face of America’s dental labs - was thrust into the spotlight. They have launched a website, http://www.whatsinyourmouth.us, providing consumers with information on the current lead scare.
The typical NADL lab has 10-25 employees, but of course American dental labs come in all shapes and sizes. Single-technician labs still exist, but more are closing every year. Larger labs are becoming more common, as are corporations that operate multiple labs.
Chinese dental labs manufacturing for export to the US are not basement operations. While a large American dental lab might employ a hundred technicians, one in China might have a thousand. Bennett Napier, co-executive director of the NADL, traveled to China to visit laboratories and speak with lab representatives.
Located in south China, Veden Dental Labs has 400 employees who manufacture 4,000 units a day for US and European customers. “It’s a campus environment because they’re working 24-hour shifts,” explained Napier, describing the lab’s golf course and employee housing. “It makes it easier to have employees right there and if there are peak times, the people are right there on site and they can walk 20 feet from housing and go to work.” (Take a look inside a Chinese lab.)
Not all Chinese labs have on-site employee housing. However, the three-shift workday is typical. Operating 24 hours a day, these labs are able to churn out large volumes of work in short periods of time. A crown, for example, takes about four days.
In fact, sending work to China for manufacturing can actually save time. Even including shipping, the turnaround time for Chinese work tends to be a week. Some American labs take 10 days or longer.
And at as little as $29 a unit, the price of a Chinese-fabricated crown is impossible to beat. Foreign dental labs are changing the economic reality of lab work. In 2007 alone, the number of dental implants imported to the US from China increased by 35%.
What will this mean for American dental labs? Well, things are only going to get more difficult for small mom-and-pop operations. Some theorize that US dental labs will become increasingly divided into two categories: mega-labs run with with brutal efficiency, and an upper echelon of boutique labs catering to higher-end dental practices.
Some American dental “labs” don’t actually have their own laboratories or do their own manufacturing. They would more properly be called brokers. They accept orders from dentists, then send the work to actual dental labs (sometimes domestically, sometimes internationally) for manufacturing.
All dental labs are required to label products along the lines of “Manufactured by X Dental Lab, Shanghai, China” or “Distributed by X Dental Laboratory, New York, NY, USA.” But keep in mind that a product distributed by an American company may still have been manufactured in another country.
Dentists are not required to pass this information on to their patients. This is in stark contrast to Canada, where patients must sign a consent form if their dental work is manufactured outside of the country.
Of course the FDA does have regulations for importing dental prostheses into the US, but enforcement is limited. Each and every single manufactured crown or bridge is supposed to be accompanied by a 510k form filed with the FDA. (See a sample 510k form.)
In the case of the dental industry, the FDA does not regulate the final products per se; rather, they regulate the materials. Even if a dental crown was manufactured in China, it was likely produced using materials made in the US or Europe.
Or at least, that’s what the Chinese dental labs say. But how can a dentist be absolutely certain the lab uses the materials they say they do? That’s why a trusted dental lab is one of a dentist’s most valuable resources. If a dentist has not done his or her due diligence in selecting a lab, that dentist could be held liable.
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March 26th, 2008 at 8:53 am
Jim, this is a good piece of writing. While outsourcing will always be controversial, it also offers opportunities. The trick to using foreign labs is to work with a reputable stateside lab as an access point, and let them do the actual outsourcing. Northwest Dental Labs in Seattle is such a company. I deal directly with them, and they make no bones about outsourcing. Their work is better than what I found locally at a fraction of the cost. I was referred to them by a friend for their consistent quality, not for their prices. I regard them as a competitive advantage for my practice. They certify and guarantee the materials they provide to be as identified. Any reworking is done quickly at their Seattle location, and with DHL shipping, they are very convenient. I am sure there are other choices out there, but they are a great example of a good organization. The first news I had of the current lead scare was a letter from them assuring me that there was no problem with their work, and reminding me of their standards. Having said all of that, I also use some excellent domestic labs for higher end cosmetic and implant cases, and our fees are able to reflect the differences in those costs.
April 2nd, 2008 at 4:26 am
The link provided on you website, “Dental Lab Industry Launches Web Site To Inform Consumers On Lead Scare,” provided by Medical News Today, lists paid sponsors at the bottom, for lab work from China and Mexico. The China ad offers PFM units for $24.95. I appreciate the irony.
April 3rd, 2008 at 2:51 pm
the local lab i use, which i sometimes instruct to send to their lab in china because of costs (the quality of work from china seems to be better than the local labs i use by the way) told me that their research has shown that the lead in the crown in question did not come from the lab in china but instead from a lab in the states that added some stain to the existing crown..said stain being the culprit that contained the lead.
the news media does not usually create accurate news, i have witnessed that in many personal encounters. but it is strange to not hear anyone commenting on this possible source of the lead..
very interesting if true.
dr shlom
April 3rd, 2008 at 4:59 pm
Mobile dental labs reunite the technician and the importance of communication between dentists, technicians, & patients. Dentists oftentimes would like their technicians to come into the office, custom shade, and /or discuss cases if desired. It’s awful expensive to bring your technician in the office IF THEY ARE IN CHINA !!!
What is happening in the dental industry? Dentists used to be taught lab techniques in dental school. My niece just graduated from dental school and only had one day of lab training. There is more to making restorations than just
using a template. Dentists need to embrace their technicians and use their expertise not ship their impressions to China. What happened to supporting our own country?
April 10th, 2008 at 11:43 pm
Like the clothing, jewelery and many other industries dental labs are likely to get worse. Go ahead sell your country to china and we will see 15 years down the line.
Where your kids will end up!
April 17th, 2008 at 11:28 am
You are right on the money Kristy. I was a lab technition before entering the dental field. The lack of laboritory experence given in dental school is scary!!! The outsourcing just brings it all to the surface again. In my state the three biggest dental labs also support the dental school and the dental association. They have personally turnned a deaf ear to the subject but now with our dental malpratice insurance writing them a letter saying that they will NOT insure any dentist that knowingly places outsourced crowns things are changing…..FAST!!!
May 18th, 2008 at 8:18 pm
yes I agree
August 29th, 2008 at 4:04 am
Is there a list of labs known to be using Chinese labs?
September 7th, 2008 at 2:17 am
Well it ’s about time such an article made its way into cyber space . There is no real quality control in Chinese dental labs . I am a prosthodontist having recently returned home to Africa after having worked 3 years in the corporate dentistry arena in Florida ( the kind of corporations that have chains of the cookie cutter dental offices in strip malls throughout the state .) That said it follows that such are largely concern with maximizing short term profits and all lab work was sent through a state side broker to China with spotty results leaving most of my (conscientious )colleagues tearing their hair out especially due to poor quality of removable denture work. It became evident to me that these labs hired ‘technicians ‘ that understood the technical aspects of fabricating something out of plastic but had no training nor understand how to apply it to dentistry. Neither could the state side broker communicate prescriptive instructions to the Chinese.
As far as materials used in the Chinese dental products I have no idea but at the time I was in the US, lead in toys and poison in pet food was raging which was none too comforting to be getting substandard work from China to put in someones mouth . I never told my patients where their work was from for fear of being held liable even though the corporation I worked for gave no alternatives unless one was to spend ones own savings on US labs .
The problem seems multiple fold : where its true that dental schools in the last decade have reduced prosthetic training to a minimum leaving most grads in the dark over the piece of trash they ‘re putting in someones mouth, most older dentists in the US still operating primarily insurance based practices would never be adequately remunerated by insurance companies to pay the mom & pops state side labs for better work . And the latter DO produce better work . It ’s difficult to believe what the above replies stating they have found chinese labs do better work than those in the US. That ’s impossible given the personal attention afforded by a tech that can come over to the office and see what you are talking about ( not to mention speak English ) but I suspect that like a lot of colleagues I worked with out there , if it isnt going in your own mouth and the patient tolerates it AND most important the bottom line is helped not hurt — no one needs to know . Hey, I ‘m not pointing fingers I also sent work to China and could not afford to use my savings to pay local labs (unless the trash from China just was not working out .)
Incidentally I happened across this site while searching for a dental chair from reputable chinese dental companies that are not fly by night profiteers. Their chairs and equipment LOOK good and are a fraction of the US and European versions however because my training I do plan to have my own dental lab and do my own prosthetic work.
September 21st, 2008 at 6:59 pm
Dear Dentist
i am the vicepresident of Veden Dental Labs in China
I like to give you some facts about Veden.
we have been serving as outsourcing labs for over 20 years,
Countries we work with: 25
Employies:1500
Units per day( fixed):6000
ISO certified,TUV Certified,DAMAS in progress
Own dental technicianschool ( 285 Students)
6 European Master Technician supervising the production
Fabricating both premium line and European & USA standard line.
To know more about us: http://www.vedenlabs.com