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Dental Labs: State of the Industry by Dentaltown staff

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Header: Dental Labs: State of the Industry
by Dentaltown staff

Advances in 3-D printing have made it easier to create crowns and bridges—and one recent study even tested polymer tooth resin with antimicrobial properties, a step toward keeping implants safe from bacterial damage.

A recent LMT survey found that more than 25 percent of crown-and-bridge and full-service labs have a wax printer of their own. However, as materials and CAD/CAM technology continue to accelerate, labs will be challenged to keep up—or die trying.

There's a popular third option, too: retirement. More than one-third of survey respondents planned to retire by 2020, through either shutting down entirely or selling their lab to competitors or group labs. How will further consolidation affect the industry—and how are lab owners planning for this and other challenges?

Dentaltown recently asked six dental labs to discuss these and other trends in the industry. One executive compared his field to the auto industry, in which "conventional workers are replaced by robotics and specialized-procedure technicians." And just like in the auto industry, challengers from overseas have entered the dental lab market, often at lower cost. But how's the quality? Their thoughts begin on the next page.

The lab industry is in a consolidation phase: Large labs add new locations, with a lack of any new "mom-and-pop" labs. How has your lab been affected by this trend?
Matthew J. Barth, general manager, Bayshore Dental Studio: "We've seen growth, because 'mom-and-pops' don't have the resources and capital to keep up with changing technology. Large labs should only continue to grow and drive 'mom-and-pops' out of the market."

Bloom Dental: "It has been hard to get dentists' trust and to get new orders."

Calvin Song, director of marketing, CreoDent Prosthetics: "We're already the largest dental lab in Manhattan, and have acquired and merged smaller two- or three-person labs into our facility. It's a way to add new customers and experienced technicians."

Dani Dental: "We're a 'mom-and-pop' lab that invested in technology to keep up with business growth and market demands. In doing this we're able to partner with smaller labs—offering services to help them meet client demands without purchasing expensive equipment."

Kim Solomon, vice president, Keating Dental Arts: "We haven't seen much impact from the 'mom-and-pop' lab consolidation/deceleration, but the most recent consolidation by venture capital groups is a trend that's never been seen in this industry. As the technical community ages into retirement, selling to a V.C. becomes more enticing—easy exit, assured payout, slow departure terms. The true pressure now is on lab owners who are still privately owned: can they compete with corporation-run labs?"

Luke Kahng, president, LSK121 Oral Prosthetics: "Not at all. We've always pursued technology and paid close attention to clinicians' demands. We don't outsource, so our one-stop shop service is fast, and we try to stay one step ahead of the latest trends. These business concepts have been the key to our survival and success."

Matt Winstead, vice president, Oral Arts Dental Laboratories: "Our lab has benefited from consolidation—we've grown as smaller labs have discontinued operation or been sold to other labs. I think that when a laboratory is sold, the quality often declines, which typically results in displaced accounts looking for a qualified lab to take over their orders."

What are your thoughts on the move away from metal-based restorations to materials such as zirconia and lithium disilicate: a fad, or the end of metal?
Barth, Bayshore Dental: "I don't think metal will ever completely go away, but zirconia and lithium disilicate will become the standard for fixed restorations."

Bloom Dental: "The end of metal."

Song, CreoDent: "There will always be a need for PFMs, but zirconia is the material of the future."

Dani Dental: "The market is moving toward nonmetallic, aesthetic and biocompatible materials. The increase in demand for precision-fit CAD/CAM products indicates that metal ceramics will slow down, replaced by newer, better and cheaper alternatives. That being said, metal won't ever go away completely! There will always be someone who wants it."

Solomon, Keating Dental Arts: "The trend will accelerate, because new all-ceramic materials are coming onto the market at a faster pace. High-translucency zirconia materials are encroaching on the aesthetic zone, pushing out pressable materials and custom multilayered metal/ceramics. An easy CAD/CAM process and smaller, more highly functional mills can produce products that rival pressed materials in fit and function. MBRs will remain, but will migrate to more specific indications."

Kahng, LSK121: "Thirty percent of posterior restorations will still be fabricated from metal because of the attachments we produce for complex, combination cases. Also, high-end dentists who are conservative and concerned with occlusion will still utilize PFM for their posterior crowns. But their anterior work will continue with the trend toward 100 percent zirconia/e.max material, because we have to have transparency in our work and be able to fabricate natural-looking, lifelike restorations."

Winstead, Oral Arts: "Our lab has seen a 40 percent reduction in remakes and repairs returned from clients since the uprising of monolithic metal-free crowns. Labs and dentists love the results of monolithic metal-free crowns—durability, aesthetics and conservation of prep. Eighty-three percent of the crowns we produce are metal-free, and we forecast that this number will continue to rise."

How have doctors' expectations changed over the past decade?
Barth, Bayshore Dental: "The biggest change has been in turnaround times: Doctors can email files to the lab and expect restorations back in five days, as a standard. This wasn't the case 10 years ago. The standards have increased across the board, as well—doctors expect full service, high quality, competitive pricing and quick turnarounds from every lab."

Song, CreoDent: "Dentists are more tech-savvy today. They'll shop around more for labs they want to work with, whether it's about pricing, technology or quality level."

Dani Dental: "More doctors are embracing new technology and materials—they no longer need to choose among aesthetics, functionality and lower prices. They expect all dental labs to use the best materials, fabricated with the lowest-error risk factors, and to maintain high-quality aesthetics."

Solomon, Keating Dental Arts: "The expectation that you can now cement a ceramic (zirconia) product in the mouth and it will not break has changed the landscape. With CAD/CAM, IOS and faster lab processing, dentists expect better products, faster, at lower cost. Still, today the conventional impression still rules—the digital wave is building, but cost and adaptation levels are still at early-adopter levels."

Kahng, LSK121: "Dentists have become more price-conscious and aware of the number of labs available to them. This is the biggest change I see: more attention to price, and willingness to change labs when they see an offer that looks like it will save them money. However, they still want quality, and most will still pay for it."

Winstead, Oral Arts: "Doctors expect labs to be more professionally managed than in previous years, and anticipate that today's labs will offer new products and technology as well as value-added services that make their lives easier. Doctor's staff members are also expecting more from the labs they use—they're key liaisons between labs and doctors, as well as influential in the choice of lab."

Lab trade groups have worked hard to get the message out that "Made in the USA" is important. Do you think outsourcing is a battle we can win? If the early battle is around price, will the long-term victory still go to quality?
Barth, Bayshore Dental: "With technology, this is a battle we can win. CAD/CAM technology has made the USA a viable option for producing high-quality restorations. American labor will continue to cost more than that of other countries, but with technology, restorations can be produced at a low cost. In the end, doctors are looking for quality. Low pricing doesn't matter if the quality isn't there." 

Bloom Dental: "We do agree [quality will win out]."

Song, CreoDent: "The trend toward digital and new technology will help bring back some of the cases going abroad. Quality alone will not do it, but consistent quality and service will."

Dani Dental: "There will always be a battle over prices and quality. As more companies turn to outsourcing for better financial returns, smaller labs will be forced out of business if they can't find a way to compete. To survive, they'll need to convert more labor costs to machinery and to produce a high volume of products."

Solomon, Keating Dental Arts: "We've always defended the 'Made in the USA with FDA-regulated materials' message. It's a battle that can be won, but it must be won by awareness. Price and quality have always been disputed. Now, with CAD/CAM and digital processing, price will align with value in terms of time and materials. Our focus is to work with our dentist to produce exceptional results; relationships foster on communication and education."

Kahng, LSK121: "Based upon the desires of their patients, some doctors require higher standards of quality from labs. Many of those doctors are left wondering if they've in fact received what they want from their lab. Dentists are just like everyone else—they'll shop around for the best value. It's their privilege and their right. We'll continue to see a trend toward bigger labs, and possibly a losing battle for the medium- and smaller-sized labs unless they can find a way to move in this direction. We must provide value."

Winstead, Oral Arts: "At the end of the day, doctors have to make choices that protect their profit margins; whether that means a low-cost lab or a high-price, high-quality lab depends on the business model of the practice. A doctor's main concern is how a lab affects his or her ability to be successful. Domestic and foreign labs alike must create compelling value propositions for their clients to remain loyal and profitable." ¦



Dentaltown Magazine
April 2024
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