Why Dentists Switch Laboratories

LMT Communications, Inc.

In LMT’s joint survey with Dental Economics, 46% of dentists say they’ve switched their primary laboratory—meaning the one they use most often—in the last five years. Here’s what leads them to end laboratory relationships and what they look for next time around.

The more things change, the more they remain the same: while dentistry has undergone unprecedented changes over the last 25 years, the number-one reason dentists switch laboratories has steadfastly remained the same: inconsistent quality.

Dentists first told us this in 1994 and have emphasized it in all of our dentist surveys since, including the most recent one conducted with Dental Economics (click here for survey demographics), where 71% said inconsistent work was the impetus to end their relationship with their last laboratory. The unpredictability of what they might receive from the lab hits dentists where it hurts the most, costing them chairtime and damaging their relationships with patients.

“Too many adjustments. Too many returns. Too much chairtime,” says a dentist-participant from Vermont. “That was the situation last time I switched laboratories. I hate adjusting porcelain; the micro fractures lead to breakage and then I have to explain to the patient why the crown needs to be replaced.”

As in the past, some dentists say the quality of work they receive from laboratories routinely starts to decline as time goes on. “What labs do is tough and good work should be applauded. But I just hate when I use a lab for awhile, then start getting back junk. I literally have used the same burs, the same impression trays, the same material, etc. but am told it’s my fault when cases start coming back incorrect,” says one. “Then I switch labs and magically everything is perfect again for a while. That gets old.”

Although laboratories have long lamented price-shopping dentists, price is a distant second to inconsistency, with only a third of dentists saying it was a factor last time they switched labs (see chart). In fact, the majority of dentists say they expect labs to increase prices once a year or every two years.

While this seems at odds with what we hear from laboratory owners, it likely comes down to a misperception: what laboratory owners may perceive as shopping for price, dentists view as shopping for value. In other words, the prices they’re willing to pay are in direct correlation to their estimation of the quality of service they receive.

For example, one dentist switched from his last lab because a fee increase and reduction in staff coincided with a perceptible decline in quality; he suspected the lab started outsourcing without acknowledging the change. Another dentist says he knows he pays higher-than-average lab fees but feels the ease of the relationship and excellent work are worth it.

A dentist from Illinois shares this story: he was paying $155 for a hard/soft nightguard at his long-time laboratory and came across a similar one at a larger lab for just less than half that price. “I called my technician and then sent him a sample of the other lab’s nightguard; he agreed it was similar in quality to what he was offering but acknowledged he didn’t have the thermoforming equipment to enable him to produce it for that price,” he says. “We had an honest and upfront conversation; I would never end our relationship just because of price, but if there’s something that doesn’t sit right, I’ll talk about it with him.”

There’s a tie for the third most common reason dentists change laboratories: delayed turnaround/late cases and prescriptions not being thoroughly followed. “When a technician doesn’t read and follow an Rx, the lab needs to be replaced. The problem—especially when you work with a lab for awhile—is the technicians assume they know what you want and then stop reading the instructions thoroughly, causing delays and frustration,” says one dentist. “Read the Rx and follow it! If you disagree, call to discuss your concerns.”

When dentists are ready to make a move, the top features they look for in a new laboratory are high-quality work, good communication and reasonable prices, in that order (see chart).

To find that new lab, they value their colleagues’ advice more than anything else; in fact, 44% of dentists say a referral from another dentist is how they found their last laboratory. They also respond to in-person sales calls and seeing samples of the lab’s work.   

When Loyalty Lasts

In all this talk about switching, let’s not overlook the fact that many dentists are relatively loyal to their laboratories: in the past five years, half of them have NOT switched their primary laboratory.

Our dentist-participants also acknowledge the positive connection they have with their technicians: nearly all say their relationships with their current laboratories are good or even excellent, and many noted it takes effort on both sides to make quality work and effective communication happen. “I’m not one of those dentists who call and scream at the lab when something goes wrong with a case,” says a dentist from Missouri. “It’s just as easy for me to screw up too. I work hard to give my lab quality work and I appreciate the quality I get back.”

Repeatedly, dentist-participants say a commitment to consistent quality, effective communication and the assurance they can rely on their labs is the key to a long relationship. “My technician and I have been working together for 30 years; he has great skills, helps me out when I get stuck, suggests clever ways to find solutions and is my friend,” says Dr. John Leitner, Grand Haven, MI. “It’s pretty simple, really.”  (Read profile of Dr. Leitner and Laboratory Owner Rick Knecht here)