PENNY-WISE, CROWN FOOLISH – SEPTEMBER 2022

PENNY-WISE, CROWN-FOOLISH

Dental practices are not the only entities suffering from a lack of abundance of suitable potential employees.  The dental lab industry has also been hit by an exodus of trained technicians and a shortage of workers to take their places.  Increased busyness in the labs from dental practices picking up their productivity has also meant that many technicians new to the field have been inadequately trained on the need for the absolute perfection needed for fit and function of the crowns and prosthetics they are creating.  The result is that dentists are increasingly finding that their lab cases are delayed or not meeting their standards for fit.  This, then, requires longer delivery appointments, and it results in frequent remakes, reappointments and eroded patient confidence.

Time is money.  The biggest expense to any practice, other than team compensation is lost production time.  We normally think of this in terms of cancellations and broken appointments.  We ask offices to track open appointment time each month and calculate the impact on the practice.  If we assume that a doctor is producing $600 per hour and a hygienist is producing $150 per hour, then just eight one-hour open appointments for each of them during a month could cost the practice as much as $6,000 in lost production, the equivalent of an entire wasted day of office time.

What often goes unnoticed is the lost production time, and increased work, that can be attributed to compensating for delayed deliveries, or less than adequate crown fit.  During a recent practice observation I saw that crown deliveries were being scheduled for as much as an hour.  The scheduling coordinator said this was made necessary by the increased time it had been taking to adjust crowns to make them fit.  Delivery of a crown should never take more than a half hour.  If a crown is taking more than 10 minutes to adjust to make it fit, it probably should have been remade.  With digital impressioning and workflow, there is no reason that a properly fitting crown cannot be seated in a minimum amount of time.  When we are taking an hour to cement a crown on a daily basis, the doctor described above has lost as much as $5,000 production in a month.  Even worse, is having to reschedule patients because a crown does not fit.  The doctor mentioned above recalled that seven crowns had needed to be re-impressioned, and deliveries rescheduled, in recent weeks.  This amounts to an additional $4,000-5,000 in lost production.

I find it disturbing when I hear that a doctor is seeking a new lab and is deciding primarily based on price.  The difference in cost of digitally produced crowns (even actual impressions are converted to digital flow by the labs when they scan the impressions) is minimal, generally ranging from $99-129, The difference is far less than the cost of lost production time caused by poor fit.  The decision on which lab to use should be exclusively based on the quality of the work and the fit of the crowns.  My suggestion is to contact the doctors in your community who have the best reputation, or local prosthodontists, to find out which labs they use successfully, and begin your search with those recommendations.  The additional cost will be more than off-set by the savings in experiencing less lost productive time.  Don’t be “Penny wise and Crown foolish.

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