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.Dentists and dental labs

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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Dentists Say Lead Is Dentistry’s Biggest Health Threat

Other Dental Health Concerns Include Mercury and Bisphenol-A

In this survey, we asked dentists how concerned they are about various potential public health threats linked to dentistry. Dentists’ concerns, in order, are:

General dentists versus specialists

  1. Lead in dental lab work
  2. Mercury in amalgam
  3. Bisphenol-A in composite, and
  4. Fluoride in water supplies.

General dentists had higher levels of concern on all issues than specialists. However, specialists and generalists agreed on the relative dangers of the chemicals covered in this survey.

Dentists’ thoughts

  • “I’d like to be doing all gold restorations.” (New Jersey dentist)
  • “All four of these need to be totally nailed down as to their safety, or lack thereof.” (Arkansas dentist)
  • “Two things that will bite dentistry in the butt are fluoride and amalgam if we don’t stop forcing them on the public.” (Idaho dentist)

Mercury

  • “150 years have not proved Amalgam to be dangerous.” (Arkansas dentist)
  • “Amalgams have saved billions of teeth!” (Washington dentist)
  • “A known toxin, no safe levels, should be banned.” (Louisiana dentist)

Lead

  • “Lead in dental casting alloy? Outrageous!” (Colorado dentist)
  • “Recent articles have debunked the worry over the amount of lead in ‘farmed-out’ crowns. Still, we need to monitor that work.” (California dentist)

Bisphenol-A (BPA)

  • “This stuff is everywhere. Composites without BPA just don’t hold up well.” (Wisconsin dentist)
  • “It’s probably not too dangerous, but don’t cast stones, Mr. Composite: you live in a glass house!” (New Jersey dentist)
  • “It’s ironic that many patients are removing long tested amalgam and replacing them with bisphenol composites of unproven safety.” (California dentist)

Fluoride

  • “It’s been shown to be effective, but we shouldn’t be medicating the whole population.” (Colorado dentist)
  • “The best public health measure ever instituted in this country for caries prevention.” (Texas dentist)
  • “Known to be toxic.” (California dentist)

Post your thoughts or read the complete dental public health threats survey results

Foreign Dental Labs Cause a Stir Among Dentists (video)

Foreign dental lab safetyIn light of reports of dental crowns manufactured in Chinese dental labs that may be contaminated with lead, we conducted a survey of dentists on the topic of foreign dental laboratories.

Two out of three dentists think that the current publicity is just a tempest in a teapot, while the remainder expect it to be the next big health scandal.

Read more: Dental Lab Safety Concerns

Dental Materials Safety Concerns (video)

Dental materials safety: who's responsible?The safety of dental materials has been in the news due to concerns about BPA in sealants and composite and reports of dental crowns manufactured in foreign dental labs that may be contaminated with lead.

So we asked dentists who should be responsible for the safety of dental products. One third said the FDA, one quarter said dental labs should police themselves, and 41% said dentists should take responsibility.

“My local lab is placing ‘made in America’ on all of the return cases for the patients to see,” mentioned one dentist.

“Too many dentists are accommodating low dental insurance payment schedules by buying their dental materials and laboratory fabrications that are too cheap,” complained another. “It doesn’t seem to matter that it compromises the health of the patient.”

Read more: Lead found in dental crown from China: Dentist Survey Results

Dental Labs: Foreign Versus Domestic (video)

Dental Labs: Foreign Versus Domestic (video)In the past, it has been reported that some dental crowns and bridges may be tainted with lead.

People quickly assumed the problem was with foreign dental labs, particularly those in China.

The Wealthy Dentist conducted a survey asking dentists a number of questions about foreign dental labs.

One dentist said,  “Patients have been systematically kept in the dark when it comes to dental procedures.  Patients should be given informed consent when choosing materials.”

Another dentist complained, “Too many dentists are accommodating low insurance payment schedules by buying materials and fabrications that are too cheap.  It doesn’t seem to matter that it compromises the health of the patient.”

Click on Play to hear more of what dentists have to say about foreign dental labs

What has been your experience with dental labs?

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