Laboratory Registration is Not the Answer

Dear LMT:

A recent issue of Dentistry Today featured an article, "Dental Lab Registration: Dentists Leading the Way", written by attorney and NADL Chief Staff Executive Eric Thorn, who points out some interesting trends in states that are creating legislation or proposals requiring dental lab registration (including Virginia, Georgia, Minnesota, New York, New Jersey, California and Washington). Thorn says that, in many cases, the reason for the growing push for lab registration is the leadership of dentists and state dental associations. I wrote a letter to Dentistry Today in response to the article, and also wanted to share some of my sentiments with other lab owners through LMT.

Are dentists really leading the way? If so, which way? Dental laboratories, I would argue, are most interested in engaging, educating and empowering both dentists and patients about choices, benefits and risks of source materials. But dental lab registration does little to accomplish those goals.

If the health and well-being of patients is really at risk (and I believe it is), why does it seem that many dentists allow insurance reimbursements to dictate what they will pay for crowns and other restorations? Of equal importance, do they know which materials are used to make these restorations?

Is the consumer even aware that many crowns for U.S. patients are made overseas (the majority in mainland China)? As a full service lab owner with more than 25 years experience, I know as do most lab owners, the patient is generally unaware a dental lab even exists, let alone that a patient's crown is custom made for him.

In a global economy, the opportunities to buy products from many countries other than the U.S. are vast, and the reason is almost always price. Dentistry is not exempt from this. Many dentists both knowingly and unknowingly use these overseas labs. Yet dentists I have spoken to seem either unaware of or claim to be unaware of this proliferation of global providers, even though they advertise in nearly every dental journal. When I've asked dentists about this, their responses remind me of a former policy of our armed services: Don't ask, don't tell.

You have to wonder why a number of the state legislative movements are requiring labs to register yet the patient still has no idea what is going in his mouth. Shouldn't the patient be aware of the origin of the product and the materials being put into his body?

Why is the dentist exempt from providing the patient with options; shouldn't the patient have a choice between using an overseas laboratory versus paying a premium for a lab that follows U.S. health and safety standards? Informed consent is always important and should be here, too. I believe patients value the freedom to choose, especially when their health could be at risk.

Until these fundamental questions are answered and acted upon, there is little reason for any of us in the dental profession to think we're moving ahead in the best interest of the patient by requiring the registration of dental labs.

Like many lab owners, I readily accept (and embrace) the idea that all labs should voluntarily comply with origin and material disclosures. We would also welcome dentists to truly lead the way in offering the patients the ability to make an informed consent decision.

~ Larry Borman Owner Tetra Dynamics West Babylon, New York

Also see Laboratory Owner Terry Fohey's Letter to the Editor, "Why is Dentistry Afraid of Transparency?" »