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The better the communication between you and your lab technician, the better the outcomes for your patients. This may seem pretty simple, but there are many reasons why dentists and lab technicians experience breakdowns in communication—and these breakdowns can affect patient care.

Even though it may take some work on both ends, there are ways to get over those communication hurdles. We recently spoke with Dr. David A. Felton, Professor in the Department of Prosthodontics at the University of North Carolina School of Dentistry, who offers advice to help you build a stronger relationship with your lab technician, which will lead to happier, more satisfied patients.

DPR: What are the biggest communication barriers between dentists and lab technicians?

Dr. Felton: Recent dental graduates are probably not trained in how to do various laboratory procedures nearly as well as we were a number of years ago. The emphasis on laboratory technology in dental schools has been replaced with instructional materials that are more clinically relevant. Hours of curriculum time have been lost, and training dental students how to do laboratory procedures has become a low priority. If dentists don’t understand how a dental prosthesis is fabricated, how do you expect them to know how to communicate with a laboratory technician about patient care at even the most fundamental levels?

The second thing is time and distance. With increased access to care issues, there are many patients and too few providers. And we’ve moved from small local dental labs to more regional mega labs. Being able to sit down and have a face-to-face conversation with a laboratory technician is really a diminishing luxury. While some of this can be done electronically, sitting down with a technician with a set of articulated diagnostic casts is crucial to having everybody on the same page with patient treatment and minimizes problems later.

DPR: What can dentists do to help get past some of these barriers?

Dr. Felton: Using digital cameras to document work pre treatment, during treatment and post treatment and sending those images to the laboratory will help. It’s also worthwhile to visit the laboratory you’re working with. Learn who the technicians are and what materials they’re using. Meet with the technician early in the treatment process to discuss patient care using the diagnostic records you’ve generated.

Dentists need to take great impressions, whether they are preliminary impressions for diagnosis treatment planning, or final impressions for fabrication of prostheses. If you ask technicians what’s the biggest short fall, most will say dentists simply don’t take good enough impressions. That’s a huge issue.

DPR: What can dentists expect lab technicians to do to help improve communication?

Dr. Felton: Have a phone conversation with the doctor if there are questions about what the dentist is asking for. Sometimes technicians will call and sometimes they’ll just attempt to do what you ask whether it can be done well or not. They need to have a good enough working relationship with you that they can say “you sent me this impression but I just can’t read the margins (or some other valuable information is missing), would you go back and make another one because we’re going to have a compromised situation here.”

It comes down to honesty and integrity and the willingness to do whatever is necessary to serve the patient, whether it’s from the doctor to the technician or the technician to the doctor. It’s a two-way street.

DPR: How does good communication benefit patients?

Dr. Felton: Clearly the patient wants to spend as little time with as few remakes in the dental chair as possible. The better the communication, the more likely a positive event will come out of the treatment. Realistically someone has to take responsibility for the patient’s care, and that should be the doctor.

DPR:  Is there anything else you’d like to mention?

Dr. Felton: Most doctors should understand that in spite of the fact that what goes into the patient’s mouth is ultimately their responsibility, the lab technician plays an integral role in the provision of the work. The best clinician’s work can look average if he or she uses an average technician. Conversely an average doctor can look great with the services of a great technician. An open dialogue and optimum communication between the dentist and the laboratory technician is crucial to a successful, esthetic outcome.

Finally, both doctors and lab technicians need to take responsibility for failures. Failures are going to occur. It’s just part of the natural life of dentistry. We need to remember there’s a patient attached to the other end of every prosthesis we deliver. Rather than argue about who’s fault it is when something goes wrong, it’s always best to move forward and treat the patient.

Check out the September issue or click here to read Dr. Felton’s Everyday Dentistry column, “It’s all part of the plan,” The article focuses on treatment planning for comprehensive prosthodontic cases.

A little extra help

General dentists and laboratory technicians need to know that help in diagnosis and treatment planning is available. Visit the American College of Prosthodontists Web site (prosthodontics.org)  to locate a prosthodontist in your area. These prosthodontists are often willing to assist in problem solving difficult patients, diagnosis and treatment planning complex cases and assisting in resolving difficult laboratory related issues.