If I were starting my dental career over again, I’d do many things differently. One is I would never say “the lab” to my patients. I would also never send a patient to the lab for a custom shade. There is absolutely no upside to telling a patient anything about your dental lab, no matter how great the lab is, and blaming “the lab” is detrimental to your practice.
You may think I’m crazy for suggesting this, but as a dentist who has practiced for more than 22 years who also owns a large commercial lab, my unique perspective gives me insight that you might want to consider.
Why you don't say "the lab"
Why would I banish all references to “the lab” in my practice? First, your patients think you make their teeth, not some random person somewhere else. Even if they don’t think you do all the work yourself, they think you at least supervise it. They have no clue what a dental lab does, nor do they care. They think that’s part of your job and that’s why you charge so much money for a crown and why you went to school for so long.
They trust you, and you want to build on that trust by convincing them how great you are so they’ll keep coming back. When you explain that their new tooth is made by the incredible artists at Ampersand Dental Solutions, you’re shooting yourself in the foot. When you tell them the lab messed up and you have to send it back and they’ll need to come in for another appointment, you’re again shooting yourself in the foot.
Now, I’m a firm believer in giving credit where credit is due but save that for your study club or next conversation with your dental friends. Telling patients how great or bad your lab is makes you and every other dentist look like nothing more than a middleman who could be replaced by a direct-to-consumer internet model of dentistry.
When you blame the lab for something (we’ve all done it), a patient may sympathize with you to your face, but they’re really blaming you because you’re the one who chose the lab they didn’t even know existed. Stop making excuses and start taking responsibility for your decisions. When your patients realize you didn’t make the tooth, they’re disappointed. You just told them the real magic is being done somewhere else. That’s not a good way to build a practice long term. Every dentist knows that a great lab makes the dentist look good, but the patient doesn’t need to know this.
Have you ever had a patient tell you that their old dentist made the “cap” themselves? The first thing you think is, “They must have a CEREC in their office.” That’s one possibility, but the other is that the dentist never told the patient about the lab, and the patient assumed the dentist made the crown.
I know some dentists who give their patients the lab bill. This makes no sense on so many levels. Dentists who do this point to the medical model of how physicians charge for their time and the patient receives a separate bill for the lab work. First, if you’ve been able to make this scenario work, you can be even more successful not doing this. You are succeeding with that concept despite yourself, not because of it. Moving away from it will make you more successful. Stop ruining the perception your patients have about you. They think you’re an amazing artist and healer.
No special cameras needed
There is no need to send a patient to the lab for a custom shade in 2025. The days when you needed a $3,000 camera and needed to take a special dental course about settings to get a good picture are over. The phone you have in your pocket is better than the expensive camera you did (or didn’t) buy years ago. Your smartphone is all you need to capture the info needed to eliminate all in-lab custom shades. The key is to take the right pictures. That’s where the dentist can mess up.
The equipment is not the limiting factor now; the operator is. The only thing your lab knows that you don’t is what pictures to take and not take. The key to a custom shade is taking good pictures with the correct reference points. You must have shade tabs in your pictures. You must make sure the lips are retracted enough to see the entire tooth. That’s it. Shade taking is not difficult.
Your patients will thank you for not requiring them to “go to the lab.” Your lab will gladly teach you how to get the pictures they need. They don’t want to be inconvenienced by your patient either. They want you to know how to take shades and get great pictures. If you don’t have the new Vita 3D shade guide, get it. The Vita classic shade guide was made for picking out dentures 100 years ago. It was never intended to match real teeth. The 3D guide is vastly superior.
How to replace “the lab”
Instead of “the lab,” use “we” when you reference lab work. A good lab is an extension of your practice. When you start taking credit for the good lab work, you’ll also have to share in the blame for the bad. When you take ownership of your lab situation, you’ll stop making excuses for poor lab work and realize how important a great lab truly is. Your patients will not stay with you, no matter how good you are, if your lab work isn’t as good as you are.
Patients don’t expect you to “make the crown fit” with a multitude of adjustments. In their mind, the last crown they got from a “good dentist” didn’t require a bunch of adjustments, but the last crown they got from a “bad dentist” did require a lot of adjustments. Both dentists are probably equally skilled, but one of them wasn’t trying to boost profits with cheap lab work. Your patients will not be happy if they know you were making decisions about what goes into their mouth based on prices over quality. You’re not going to build the practice of your dreams using a cheap lab.
Time is money for both you and your patients. For you, time is the most valuable commodity. Your earning power is directly related to the number of billable procedures you do. Adjusting crowns is not billable. Patients will not blame “the lab” for all the adjustments you make to fit the crown. They’re not going to blame “the lab” if they don’t like the crown. They’re going to blame you, no matter how good you are or how many times you try to blame “the lab.”
A bad lab will cost you much more than you save. A great lab can help you build your practice and keep your patients happy. Just keep that secret to yourself, and let patients believe you make all the magic happen.
Editor's note: This article appeared in the February 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
