Dentists Must Do Their Due Diligence
With recent news that some dental prostheses may be contaminated with lead, a lot of dentists are wondering if they’re legally liable for the quality of their dental lab work.
Unfortunately, there’s no simple answer to that question. However, one thing is clear: if you, the dentist, haven’t done your due diligence in selecting a reputable dental lab, you could be held responsible for the quality of their products.
“The liability situation is the same as it has always been, each party, the dentist and the dental laboratory must do their due diligence to comply with existing laws and regulations,” said Bennett Napier of the National Association of Dental Labs (NADL). “The liability exposure is different in each case specific scenario depending on a number of factors.”
But what exactly does “due diligence” mean? Well, it definitely means that you’re not choosing a dental lab on the internet because they have the cheapest crowns available. It does mean that you’ve researched your lab. Ideally, you’ve talked to the owner, visited the premises, and heard good reviews from other customers. If not… well, just be prepared for the possible consequences.
We at The Wealthy Dentist have been investigating what dentists may be able to do to protect themselves.
1. Make your dental lab tell you where the work is coming from and what it’s made of. Remarkably, most dental labs are NOT required to pass this information on to the prescribing dentist.
Florida and South Carolina have recently passed legislation that would require such disclosure, and other states are likely to follow suit soon. The NADL is working on a universal form for dental laboratories. Ohio has a similar form; the state’s dental board recommends but does not currently mandate use of these forms.
Highlights from the Ohio State Dental Board Laboratory Prescription & Point of Origin Form
Type of Restoration: _______
– Porcelain to High Noble
– Porcelain to Noble
– Porcelain to Base Metal (NP)
– Full Metal High Noble
– Full Metal Noble
– Full Metal Base (NP)
This case will be:
– Fabricated by technicians at our own dental laboratory.
– Sent to another laboratory in the U.S. to be fabricated (Lab Name & Location)
– Sent to an overseas/foreign laboratory to be fabricated (Lab Name & Location)
2. Make sure you’re giving your dental lab a full prescription.
An alarming number of dentists don’t actually give their dental labs all the information a technician needs to formulate a dental prosthesis. When information is missing (for example, what specific metals should be used), the technician is left to make an educated guess.
A checklist form can help ensure that dentists are giving their labs all the necessary information.
The Ohio State Dental Board has also released prescription guidelines. This form outlines the minimal information that should be included in a dentist’s prescription.
- Form must include basic information on patient, dentist and dental lab, as well as type of prosthesis.
- Crowns and bridges: Shade prescription, shade mapping, and material prescription.
- Partial and complete dentures: Shade prescription. tooth material prescription, tooth mold (shape) prescription, design of partial denture framework.
- Orthodontics or occlusal splints: explicit definition of type of prosthesis and instructions.
- Any additional explicit instructions from the dentist.
- Point of origin information should be included.
3. Check your lab’s credentials.
The NADL’s Napier offers the following advice to dentists: “Dentists as part of minimizing their liability risk exposure can look at working with dental laboratories that are Certified Dental Laboratories or DAMAS accredited dental laboratories where third party validation occurs to ensure the lab’s quality system includes material traceability of lot and batch numbers of materials used for a specific dental restoration.”
The National Board for Certification in Dental Laboratory Technology (NBC) has developed a form for use by Certified Dental Technicians (CDTs).
Dental Restoration Disclosure Form
This case was manufactured by:
CDT Name: ___________________
CDT Number: ___________________
at ___________________(Dental Laboratory),
in ___________________(City, State, Country)
using the following FDA registered materials in the final restoration:
[Place Identalloy/IdentCERAM Sticker Here]
4. Stay current. It’s quite possible your state is considering new legislation for dentists and dental labs. You might consider setting up a Google News Alert to keep you informed of the latest news; just use “dental lab” and your state as keywords.
Can you suggest any additional resources? We’d love to see what forms you’re using with your dental lab. Just send us an email at [email protected]!