Are Dentists Liable for Lead in Dental Products?

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)

See the full Ohio dental lab form

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.

  1. Form must include basic information on patient, dentist and dental lab, as well as type of prosthesis.
  2. Crowns and bridges: Shade prescription, shade mapping, and material prescription.
  3. Partial and complete dentures: Shade prescription. tooth material prescription, tooth mold (shape) prescription, design of partial denture framework.
  4. Orthodontics or occlusal splints: explicit definition of type of prosthesis and instructions.
  5. Any additional explicit instructions from the dentist.
  6. Point of origin information should be included.

See the full dental lab prescription guidelines

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]

See the complete CDT dental restoration form

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!

Dentists Don’t Sell Their Practices, They Sell Their Leases…

dental lease advocate Lewis GelmonThe Hidden Costs of Bad Dental Practice Leases
Special Lease Feature by Lewis Gelmon

Dentists are shocked when I tell them that you don’t really sell your practice; you sell your lease. This simple but disturbing reality has become evident to me from the thousands of leases I have reviewed for dentists since 1994.

Dentists spend decades building good will and providing excellent dental care. They spend hundreds of thousands of dollars on marketing, state-of-the-art equipment, and creating a comforting environment for patients and staff. Unfortunately, all the money, time and effort spent does not necessarily translate into a high sale price.

How can a dentist avoid that unfortunate fate? With a proper office lease agreement that has been carefully crafted for a dentist planning to sell his or her practice.

Over the years, I have been invited to speak at dental conferences (like the Greater New York Dental Meeting, the Pacific Dental Conference and countless local dental societies and association meetings) on this subject. However, my mission is still far from complete.

It seems that more and more dentists are finding themselves caught in a classic landlord trap. I receive one or more phone calls each week from dentists across the country who are in the process of selling their practice but have run into problems with their landlords. These calls all tend to sound the same.

The dentist sounds stressed on the phone. He explains that he has tentatively sold his practice. When he approached the landlord to assign the lease to the new owner, the landlord asked for a letter formally requesting the transfer of the lease to the new dentist. A few days after sending the letter, the landlord called. After reviewing the lease agreement, the landlord has determined that he now has the right to terminate the lease and remove the original dentist from the premises.

The landlord goes on to explain the dentist’s choices. He can give the space back and vacate the premises as promised in accordance with the lease. Alternatively, he can pay the landlord a fee for agreeing to waive the right to exercise their option to terminate, allowing the dentist to remain on the premises and sell the practice. Depending on location and the value of the sale, this fee is usually somewhere between $75,000 and $250,000.

Take a moment to process that: It can cost a dentist up to a quarter of a million dollars to transfer their lease. I’ll bet you didn’t know that, huh?

Property owners often understand the business of dentistry better than dentists themselves. In fact, many landlords pride themselves on such business practices as a way to share in the sale proceeds of their most valuable professional tenants. Buried deep in the lease agreement is an “Assignment Provision” that governs the details of how to transfer the lease (change of control) when selling the practice. These provisions are often extensive and hard to understand. Most allow the landlord overwhelming control over who you can sell, as well as the opportunity to prevent the sale or terminate the lease. In my opinion, the purpose of these onerous sections is simply to provide property owners with the opportunity to share in the sale proceeds of your practice when you sell.

But do you really want your landlord to make a hefty profit from the sale of your dental practice?

The solution is simple. I like the over-used but very true axiom, “An ounce of prevention is worth a pound of cure.” If you ever plan to sell your practice, you need to make sure you can first sell your lease. This requires knowing where the risks are before putting your practice up for sale. Given that there are other potential problems, the best thing you can do is to have your lease properly reviewed to ensure it’s structured correctly for sale and follows good leasing guidelines for dental offices.

Looking for more information on the topic? You can reach Lewis Gelmon at (760) 479-9704 or For only $495, he will personally review your lease. Plus, get a $200 discount until October 31 just for mentioning The Wealthy Dentist. All reviews are guaranteed. If you don’t feel you have received the value, he’ll give you a full refund, no questions asked.

Lewis Gelmon is a former landlord, lease negotiator, and shopping center manager. Now a dental tenant advocate, he regularly lectures for dental groups across North America and the UK. He is the most published author on the subject of dental lease negotiations. His Good Leasing Guidelines for Dentists have been critically acclaimed by numerous dental groups. His mission is to raise awareness among dentists on the risks hidden in their office leases.

Holistic Dentistry: Methods for the “Alternative Dentist”

Holistic dentist: alternative dentistryDentists: why should you care about “Alternative” dental approaches? Because large segments of your dental market care. In these tough economic times, it pays to know enough about these alternatives to be able to discuss them intelligently when patients ask questions about them. From a dental marketing point of view, it is imperative that you treat these questions with respect.

Do you know exactly what holistic dentistry is? How about “biological dentistry”? What about things like dental homeopathic medicine, Dental Somatic Integration™, and mercury chelation therapy?

Well, this week I’ll walk you through some of what “alternative dentistry” has to offer…

Dr. Weston Price, DDS (1870-1948) is the dentist often considered the father of the holistic dental movement. In comparing “modern” cultures with traditional, tribal peoples, he concluded that our modern diet leads to all manner of health and dental problems: caries, impacted wisdom teeth, allergies, fatigue, and even cancer. [Learn more about Dr. Weston Price]

Dr. Price also campaigned passionately against root canals, arguing that they leaked bacteria and other toxic materials into the body. To this day, many a holistic dentist opposes root canal therapy.

Holistic dentistry (sometimes called “wholistic dentistry“) – like all types of holistic medicine – dictates that the patient be treated as a whole person. This view of the holistic dentist is somewhat at odds with today’s widespread concept of dentists as oral health practitioners who have little to do with the rest of the body.

Nutrition and body chemistry are key concerns of holistic dentistry. Holistic dentists may use blood tests or hair samples to monitor patients’ nutrient levels, offering nutritional supplements or dietary counseling.

Holistic medicine strives to meet the psychological, emotional and spiritual needs of its patients, helping to tap self-healing potential. It also views the whole person as deeply connected to the person’s physical and emotional environment. [Learn more about holism]

Some holistic dentists also use homeopathic medicine, which is a particular form of alternative medicine. Based on the concept of “like cures like,” homeopathic medicines are successive dilutions of a natural substance that causes symptoms similar to those the practitioner is trying to cure. [Learn more about homeopathic medicine]

Though most often practiced by chiropractors, applied kinesiology issometimes used by holistic dentists. Dental Somatic Integration™ is based on the idea that fixing tooth problems can heal pain or injury in other parts of the body. [Learn more about Dental Somatic Integration™]

TMJ patients may be offered cranial therapy (also known as “cranial osteopathy” or “craniosacral therapy“) to relieve TMJ pain. This therapy involves manipulating the bones of the skull and jaw as well as the “rhythm” of the cerebrospinal fluid.

Biological dentistry focuses on using bio-compatible dental materials, acknowledging that different patients may have different biocompatibility. The biological dentist is particularly concerned with mercury and other metals used in dental restorations, both in terms of toxicity and “oral galvanism” (electrical currents generated by these metals). Biological dentists also argue that many patients have areas of decay and dead tissue, known as dental interference fields or foci. [Learn more about Biological dentistry]

Mercury-free dentistry (not quite the same thing as mercury-safe dentistry) has perhaps gained the most widespread acceptance. A number of dentists (according to our survey on mercury amalgam fillings, up to half of dentists) feel that mercury amalgam may not be a safe treatment. Most commonly, these dentists offer composite fillings instead. Some actually recommend patients have existing silver fillings removed. A few even offer chelation therapy as a way of removing toxic mercury from the body.

Want to learn more? Here are some links you may find interesting:

Dentist Satisfaction with Dental Associates

Dentists' satisfaction with dental associatesMany dentists have been left unsatisfied by their dental associates, this survey found. Of the dentists who have had associate dentists (71% of respondents), 31% have been mostly satisfied, 46% have been partly satisfied, and 23% have been left unsatisfied.

“The associate in my practice expected a six figure income without having to WORK for it!” complained one dentist.

Here are some additional comments from dentists:

  • “Associates never or rarely cover their expenses.” (General dentist)
  • “I hired the wife of a friend. Big mistake! She thought practicing dentistry was like going to a country club.  We start at 8 am and go to 5 pm. She would get to the office by 10 am and sometimes 10:30 am, see one patient, go out for a long lunch and shopping, maybe come back and see a 2 pm patient, and leave us with no help when we needed it.” (Illinois dentist)
  • Dental graduates have the impression that they should demand a salary that is well beyond their ability to produce it.” (Florida dentist)
  • “Associateships should be exclusively for dentists who are ready to leave a practice, not for dentists who are mid-career.” (North Carolina dentist)
  • “Don’t add an associate unless you are already too busy to handle all of the appointments that are scheduled and your schedule is currently overbooked.” (General dentist)
  • “Neither of my two past associates provided restorative dental treatment up to my standards.” (Connecticut prosthodontist)

Read more: Dental Associate Satisfaction Among Dentists

Dentists: Can Copyright Law Protect You from Negative Online Reviews?

dentists and copyright lawOnline dental reviews can be a problem for dentists when negative reviews appear, especially when they feel the review is possibly retaliatory or bogus.

A few thousand doctors have taken matters into their own hands by working with a company called Medical Justice, that created a way to use copyright law to go after negative online reviews.

For about $100.00 a month, Medical Justice protects its doctors by going to online review sites and demanding any bad reviews be removed due to “a breach of copyright.” The company instructs doctors to have their patients sign contracts that assign away the copyright in any future review the patient might be compelled to write online.

Techland Times reports that Medical Justice claims what they’re doing is not only protecting the doctors from unfair bad press, but also from bogus reviews. “Some sites say, we don’t know if you’re telling truth, and we don’t know if they’re telling the truth — it’s the Internet, so deal with it,” contends Shane Stadler of Medical Justice.

Moco News writes that by having patients assign copyright in any reviews to their doctor, Medical Justice is hoping to help doctors get around Section 230 of the Communications Decency Act (an “arcane nuance of cyberlaw,” according to Medical Justice’s website), the law that protects web services from getting sued over content posted by their users.

It is being reported that Yelp has refused to honor a doctor’s take-down notice based on copyright infringement, and another online review website called RateMDs created a “Wall of Shame” to identify doctors who are using the copyright contracts.

Sound unreasonable? Do you think it’s irrational to demand dental patients sign a copyright assignment form when they visit a dentist office?

For more on this story see Doctors Now Using Breach of Copyright to Quash Bad Online Reviews and Can Doctors Use Copyright Law To Get Rid Of Negative Reviews?


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