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In patients with obstructive sleep apnea (OSA), the most common type of sleep apnea, the mandible falls back as the brain approaches the deepest stages of sleep and the muscles of the airway fully relax, which is what causes the obstruction. When the brain senses breathing is compromised, it forces the body out of the deepest stage of sleep in order to regain control of the jaw muscles and reopen the airway. This can occur over and over during the night and, as a result, the patient’s sleep is extremely fragmented.
Left untreated, sleep apnea can have serious and life-shortening consequences: high blood pressure, heart disease, stroke, automobile accidents caused by falling asleep at the wheel, diabetes, depression and other ailments. A major symptom is extremely loud snoring; other indications are persistent daytime sleepiness, bouts of awakening out of breath during the night, and frequently waking in the morning with a dry mouth or a headache. OSA most commonly affects middle-aged...
An estimated 25 million adults in the U.S. suffer from obstructive sleep apnea. Oral appliances have proven to be a viable option for treatment and a huge opportunity for dentists and labs, but there are numerous complexities in the market.
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A record-breaking crowd welcomed LMT’s LAB DAY East to its new Atlantic City, NJ venue on September 19. More than 1,020 attendees flocked to the Atlantic City Convention Center for a jam-packed day of education, networking and comparison shopping.
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Respondents to LMT’s 2015 Marketing Survey are using new as well as tried-and-true strategies to cement client relationships, boost loyalty and increase referrals.
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Laboratory respondents to our State of the Industry 2015 survey ranked clients’ impression-taking skills as their number-one client-related challenge, saying one quarter of the impressions that come into their laboratory are inadequate, a result of dentists not following manufacturers’ guidelines, delegating the task to assistants, or just not carefully evaluating the impressions before sending them to the lab.
While 94% of laboratory-respondents say they’re comfortable calling their clients for replacement impressions, they often still hear those words that make most of them cringe: do the best you can.
“I cannot do the best I can without a good impression. Just one or two minutes of their time could save so much on both sides,” says Carol Sullivan, CDT, Owner, Dental Lab Solutions, Loveland, CO. “I often just refuse those impressions or I send the model to the doctor and ask him to trim the die or reimpress. After that happens a few times, they start...
A surge of digital technologies, the corporatization of dentistry and omnipresent insurance woes are just a few of the challenges impacting your dentist-clients. As part of our State of the Industry 2015 survey coverage, LMT polled 80 dentists from around the country to get their perspectives on these trends and more. Here’s what they had to say.
They’re hesitant about digital impressionsAlthough 41% of laboratories are equipped to accept digital impressions, dentists have been slower to adopt the technology: labs receive digital impressions from only 6% of their clients. While many dentists acknowledge that digital impressions are likely the future, those who aren’t ready to adopt the technology most often point to the high cost and what they say is a questionable return on investment.
“I believe there are benefits to digital impression systems, but like all of the amazing opportunities in digital dentistry today, a purchase has to be carefully...
CAP is now Amann Girrbach’s premier partner in North America, selling the complete line of AG equipment, material and tools, as well as enhancing training and customer support.
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Rejuvenation dentistry is an approach based on a model of health that considers not only a patient’s teeth but the entire masticatory system, including jaw joints, nerves and head and neck muscles, and maintains that problems occur when these components aren’t working in biological harmony.
- October 2014
LMT’s 2014 Fee Survey respondents offer a mixed picture of their sales and profitability. On one hand, laboratory sales seem to be slowly improving. Profits, though, seem to be lagging behind.
A 2014 Fee Survey participant from the Midwest—who prefers to remain anonymous—offers a thoughtful take on how the rampant price competition on full contour zirconia restorations is negatively affecting the bottom line of many laboratories. Here’s what he had to say:
In the early 1980s, the price of gold skyrocketed and non-precious alloy showed up on the scene. Since it was a cheap metal, most labs didn’t even add the cost of the metal into the crown fee. However, they weren’t thinking about the revenue they had been making on gold alloys—or about the increase in labor because non-precious takes longer to finish—so their profitability suffered.
A similar trend is happening with FCZ. In many laboratories, FCZ is cannibalizing their PFM work and the labs are losing the alloy revenue. And, as the economy has declined, so has the price of FCZ: the $99 FCZ was born, quickly gained market penetration and the race to the bottom began. Many labs...
- June 2014
- May 2014
Tra’ Chambers had no actual laboratory experience when he opened Express Dental Laboratory in Norman, OK in December 2012. Harnessing the efficiency of CAD/CAM technology, the lab touts a two- to three-day turnaround (or same-day for its mobile service) and generated over $300,000 in revenue during its first full year in business. Now, with a staff of seven, the lab serves 118 clients and 45% of its work is completely digital. Here’s more about the lab’s growth strategies:
LMT: What made you decide to open Express Dental Laboratory without any prior laboratory experience?
Tra' Chambers: After spending three years as the Chief Operating Officer of a multi-location dental practice, I had a good idea of what was important to a dentist’s success: for one thing, it’s cash flow. I realized that if a laboratory could provide crowns to dentists in three days or less, it would improve the doctors’ cash flow significantly because they would get insurance...
- April 2014
Owner: Dr. Dick Barnes
With more than 200 employees, it’s no easy feat to get everyone focused on the same goal. But at Arrowhead Dental Laboratory in Sandy, UT, a singular mission gives meaning to the work day: helping customers become better, more productive dentists.
“Dr. Barnes emphasizes building relationships first and building the business second; that’s really become our culture here,” says Peggy Nelson, the lab’s Director of Business Development. “In fact, the bond between the people who work here and our customers is what makes work not a chore, but an incredible privilege every day.”
Because a team is assigned to each dentist-client to ensure personal service, technicians truly feel a part of the dental team and an extension of their practices; dentists become more than just a name on a case pan. Seminars held every other week also give the staff a chance to bond with clients, since technical support representatives...
Owner: Benjamin Hart
A 50” HD TV. Ping-Pong tables. Sony PlayStation. Workout equipment. These are just a few of the amenities with which Owner Benjamin Hart has equipped the third-floor of Custom Arts Dental Lab.
Designed as a recreational area for employees, the upstairs also includes a full kitchen, laundry area, and adjoining deck with patio furniture and large gas grill. After all, Hart believes his staff is his family, and when a family gets together, it should always feel right at home.
Hart’s efforts, though, aren’t restricted to the third floor. During Halloween, for example, he turns the bottom floor of the lab into a haunted house and hosts an annual costume party at his home. There are also Christmas and Thanksgiving get-togethers and the annual Crawfish Boil on Memorial Day. “He truly treats everyone like they are part of his family,” says Office Manager Christina Turner. “I know I will never find a better place to work.”
- March 2014
Owner: Dr. James Hartzel, CDT, and Edwin Fajardo
“One day, we knew we weren’t going to make the shipping deadline for a case for one of our larger accounts on the East Coast. But we also knew we weren’t going to let that client down. The case was finished at 8:00pm and I was at the airport within an hour; 12 hours, four flights, two cab rides and a bunch of protein bars later, I was delivering that case to the dental office as the patient was walking in.
To me, my travel experience speaks volumes about the culture of this laboratory: we will always go the extra mile to keep our customers happy. Because Dr. Hartzel is a retired dentist as well as a technician, he’s able to give us all a unique perspective on what our dentist-clients really need from us. I’m really thankful to be part of a team that is so passionate about our work and our clients.
In only three years, we have transitioned from a C&B lab to a full service...
Headquartered in Ottawa, IL
Owners: Luke Caruso Sr., Luke Caruso Jr. and Jim Caruso
130 employees across three locations
If you’re at an industry meeting and meet a group of people with blinking lights on their shoes, chances are they work at Ottawa Dental Laboratory (ODL).
That blinking light would be an Actiped pedometer, a component of the laboratory’s comprehensive wellness program, which earned ODL recognition as one of the 100 Healthiest Workplaces in America for 2014, as well as the Healthiest Employer in Illinois for 2012 and 2013.
In 2004—after a string of double-digit increases in health insurance premiums—the laboratory developed a wellness program, which now includes on-site voluntary health screenings and incentive points for making healthy choices like exercise or annual physicals. The points can then be redeemed for a variety of items including movie tickets, hotel stays, digital cameras and TVs.
A cornerstone of the activity part of the program is...
Headquartered in Seneca Falls, NY
Owner: Bruce Bonafiglia, CDT
200 employees across three locations
Striking a work-life balance is a constant challenge for many of us. How can I squeeze in a workout? Who will watch the kids? When will I fit in a haircut or get the laundry done? And what’s for dinner tonight? If you work at BonaDent, all of those answers can be found within the four walls of its new, state-of-the-art facility in Seneca Falls, NY.
BonaDent’s unique amenities truly make employees feel valued and taken care of: the in-house fitness center, onsite daycare, comprehensive wellness program, weekly visits from a masseuse, and a modern hair and nail salon. Angelo’s Café (named after Angelo Bonafiglia, Founder) provides convenient and healthy choices for breakfast, lunch and take-home dinners, and the coffee shop, Brew C’s (named after Bruce Bonafiglia, President) serves up gourmet lattes and coffee daily. Employees can even use the lab’s...
Owners: Randy & Daxton Grubb
When Daxton Grubb joined his father Randy’s laboratory in 2002 after working at a Fortune 500 company, he had already learned a thing or two about employee motivation. “The company set unrealistic goals and only managers were rewarded for good performance. I was determined not to make the same mistake here,” says Grubb.
While 20 to 30% of R-Dent’s managers’ compensation is based on their department’s net profit, Daxton also has sales and incentive programs for all employees. First, there are monthly incentives: employees get $100 if their department reaches its monthly sales goals, or $200 if it exceeds its goals by at least 10%. In addition, performance-based incentives are given every three months; Daxton allocates a percentage of the previous quarter’s profit to bonuses based both on production goals and intangibles like teamwork and attitude.
On top of the bonuses, an employee recognition...
Since their introduction in the 1950s, PFM restorations have been the bread-and-butter of C&B and most full service laboratories. In fact, as recently as 2005, only 17% of C&B workloads were metal-free. However, with the proliferation of metal-free materials and technologies, we’re nearing the tipping point: 45% of C&B workloads are now comprised of metal-free restorations, according to LMT’s 2013 Porcelain Survey.
In 2010, the NADL’s analysis of the new healthcare legislation revealed that a 2.3% excise tax would be applicable to the selling price of completed dental restorations beginning in 2013.
Vague terminology in the legislation indicated that the 2.3% tax would be payable by the manufacturer, producer or importer but didn’t specifically define those terms. Given the FDA’s previous classification of dental laboratories as medical device manufacturers, the conclusion was that the tax would apply.
The news generated a growing alarm over the next several months as laboratory owners sought clarification on what the tax would mean to them. Despite the efforts of the NADL, ADA and nearly a dozen other allied dental organizations to have dental devices excluded from the tax, the IRS denied the request at a public hearing in Washington D.C. in May 2012.
However, at virtually the last minute—on December 4, 2012—the IRS released its Final Rule on the Medical Device Tax,...
The full contour zirconia trend began in 2009, with the launch of Glidewell’s BruxZir® Solid Zirconia crowns and bridges, marketed as a “virtually unbreakable” option for bruxers and grinders. Other manufacturers began to follow suit and introduce their own solid zirconia options and “Full Z” has become the fastest growing restoration in laboratories across the country.
The restorations allow laboratories to offer a lower-cost solution, and the labor-saving digital process ensures better fits and fewer remakes. There remains concern among some laboratory owners about zirconia’s increased wear on opposing dentition, although advocates say that maintaining a high polish reduces the problem.
Manufacturers continue to introduce new zirconia materials to address the question of esthetics and laboratory owners are taking note. “The days of using 20 different porcelains to build up a tooth, as the first option, are long gone. You can get esthetics...
On the heels of widespread media attention about offshore crowns containing lead, two bills that required laboratories to spell out the origin and content of dental restorations passed in 2008: one in Florida and one in South Carolina. Although both bills only required the lab to provide the information to the dentist—and not for the dentist to pass the information onto the patient—supporters felt it was a step in the right direction because the information would be placed in the patient’s file and would provide a mechanism for traceability.
Illinois, Ohio and Minnesota have also passed disclosure laws; similar legislation is pending in Virginia and Kentucky, and efforts are also being made in New Mexico, Colorado and California. Although it’s not a law in Missouri, disclosure is a “best practice” requested by the state dental association. To date, there are no laws requiring dentists to disclose point of origin to the patient.
Foreign Dental Work Put to Test, an investigative report about lead found in restorations made in China was the talk of the industry when it aired in February 2008 on Ohio’s WBNS 10TV. The story covered an Ohio woman who had experienced pain and infection in her jaw after her dentist placed an ill-fitting, three-unit PFM bridge the previous year. After learning the bridge was made in China, she had the bridge removed and tested for hazardous materials, and lead (160ppm) was found in the restoration.
In addition, the TV station ordered eight PFM crowns from four labs in China and also had them tested; one of them tested positive for lead (210ppm).
The media coverage fueled objections to offshore outsourcing and even breathed new life into the debate about mandatory laboratory certification and registration. The ADA announced it would do its own independent testing and released its findings a year later: scientists analyzed 44 different porcelain powders and 102 finished PFM crowns...
The buzz at the Dental Laboratory Owners Association of California’s CAD/CAM Symposium in November 2005: rapid prototyping technology. First developed in the 1980s and used in the automotive and aerospace industries, the technology had laboratory owners enthusiastic about what was called the “next generation of CAD/CAM.” Advocates said the additive technology would result in increased efficiency and less material waste.
Those forecasts were spot on. The technology continues to revolutionize the way laboratories fabricate waxups and metal restorations. And, like CAD/CAM, it’s changing things quickly. Since 2011, the percentage of laboratories who offer 3D printed metal restorations has tripled (from 8% to 24%) and the percentage with a rapid prototyping system for wax has more than doubled (from 8% to 17%), according to LMT’s Digital Technology Surveys.