Tooth Reduction

[Ken Knapp]

I have a new dentist client that was referred to me that continues to have improper preparations that are nearly parallel and sometimes with a reentrant angle. Most of the time I have to modify the preparations down to the margin.
I have had a couple of remakes from this and i'm getting tired of the time spent adjusting the dentists preparations.

What to do.......I have given the dentist a preparation guideline and talked about a proper preparation.

I am no longer covering remakes where I have to adjust the preparation.

Should I start charging for preparation adjustment?

Ken

 

[2thm8kr]

I have a new dentist client that was referred to me that continues to have improper preparations that are nearly parallel and sometimes with a reentrant angle. Most of the time I have to modify the preparations down to the margin.
I have had a couple of remakes from this and i'm getting tired of the time spent adjusting the dentists preparations.

What to do.......I have given the dentist a preparation guideline and talked about a proper preparation.

I am no longer covering remakes where I have to adjust the preparation.

Should I start charging for preparation adjustment?

Ken

Talk to the guy one more time and inform him that you will have to charge for prep adjustment if this continues. If the guy doesn't whine about
paying for remakes he should be happy to pay this fee instead of full price for another.

If you get no where fast with this approach, pick up another client and dismiss this one. He is cutting into your profit by adding extra time to get to the finish line with his cases.
These types of guys are the ones I weed out. It ends up costing you money and a lot of extra time to do their work.

 

[2thm8kr]

Are you just blocking out the cases or are you making reduction copings for every prep?

 

[Ken Knapp]

Are you just blocking out the cases or are you making reduction copings for every prep?

Marking the preparation die. He does not want, (to pay for),a reduction coping. He is cheap...keeps asking about discounts and has the worst preparations.

 

[2thm8kr]

Probably time to let that one go.


That type of client is what the big box labs are for.

 

[Ken Knapp]

Probably time to let that one go.
View attachment 18961

That type of client is what the big box labs are for.

Yes, I agree. Funny, this dentist was referred to me by one of my best dentist clients.

 

[JKraver]

Send the good dentists flowers or a basket. When he asks what it as for tell him. I thought you must be mad with me for referring me to that dentist.

 

[rkm rdt]

Ken,if you are scanning these cases,perhaps you could show him a screen shot of the undercuts.

 

[2thm8kr]

Ken,if you are scanning these cases,perhaps you could show him a screen shot of the undercuts.

Or a 3d PDF file.

 

[JKraver]

Those undercuts in red really make an impression. Great idea.

 

[rkm rdt]

Those undercuts in red really make an impression. Great idea.

It's definitely a stfu moment when you tell him it's the scanner talking!

 

[Patrick Coon]

Marking the preparation die. He does not want, (to pay for),a reduction coping. He is cheap...keeps asking about discounts and has the worst preparations.

As 2thm8r suggests, I would have a sit down with him and explain the situation again. I would let him know that for any prep I had to adjust There will be two extra charges, one for adjusting the die and one for a reduction coping (and I would require him to accept the reduction coping).

And if this continued with him I would raise my prices for him every month. If he really likes your work he will stay, but if he is as cheap as you suggest he will find another lab very soon.

That's my $0.02.

 

[rkm rdt]

Good advice Patrick
You should raise your fee to $0.03 as well.

 

[PearlZ]

if i had a nickel, etc etc.

 

[CreativeTech]

I have a new dentist client that was referred to me that continues to have improper preparations that are nearly parallel and sometimes with a reentrant angle. Most of the time I have to modify the preparations down to the margin.
I have had a couple of remakes from this and i'm getting tired of the time spent adjusting the dentists preparations.

What to do.......I have given the dentist a preparation guideline and talked about a proper preparation.

I am no longer covering remakes where I have to adjust the preparation.

Should I start charging for preparation adjustment?

Ken

Just ditch the guy. No doubt you have paying clients & a family. They're more important.

edit; If he asks why, be honest. Tell him you can't afford him.

 

[Sevan P]

I charge every time I have to finish what the Dr didn't. $35.00 for a reduction coping. Scan die, mill out of red PMMA reduce coping while on the die and done!

One Dr pissed me off on a 6 unit lower anterior bridge all 3 preps are no where near parallel draw, Dr said just get it done!!! No problem 'A' hole, I reduced the **** out the preps finished the case sent it back, Dr call after seating and bitched at me for having to do 3 rout canals on the PT for free.........................LMFAO next time dumb ass listen the lab when they say it is highly recommended that you reduce and re prep cause the prep is reduced a lot and near a possible root canal. (That Dr is a hack anyways so what goes around comes around I guess.)

Absolutely charge him for any remake cause he couldn't reduce the prep in the first place, but in order to do that you must provide him with a reduction coping. I call it C.Y.O.A. Cover Your Own Ass then they can't complain.

 

[2thm8kr]

I charge every time I have to finish what the Dr didn't. $35.00 for a reduction coping. Scan die, mill out of red PMMA reduce coping while on the die and done!

One Dr pissed me off on a 6 unit lower anterior bridge all 3 preps are no where near parallel draw, Dr said just get it done!!! No problem 'A' hole, I reduced the **** out the preps finished the case sent it back, Dr call after seating and bitched at me for having to do 3 rout canals on the PT for free.........................LMFAO next time dumb ass listen the lab when they say it is highly recommended that you reduce and re prep cause the prep is reduced a lot and near a possible root canal. (That Dr is a hack anyways so what goes around comes around I guess.)

Absolutely charge him for any remake cause he couldn't reduce the prep in the first place, but in order to do that you must provide him with a reduction coping. I call it C.Y.O.A. Cover Your Own Ass then they can't complain.

Hopefully you are just kidding about the root canals.

 

[Tayebdental]

Suggest a PFM bridge and Fabricate the bridge with precision attachments and charge more!!.

 

[Ken Knapp]

Just ditch the guy. No doubt you have paying clients & a family. They're more important.

edit; If he asks why, be honest. Tell him you can't afford him.

I have another problem case, 3 unit bridge, from the same dentist. Under prepared and path of insertion undercut at the margin in addition to a huge pull across the buccal margin on #6.

I asked the dentist for a new impression and explained the margin problem. He asked me to modify the preparation including the MARGIN and mark the model.

After thinking about this, how in the world will the margins fit after the dentist modifies the tooth margin by eye with this method. A preparation template would be needed to make this work provided I can see the tooth below the current margin, which neither is true.

This is a no win case, for the patient, dentist and me.

I have decided to return and decline the case and outline my new die preparation and case return fees.

Dentist complained after last case with prep modification and potential root canal as if it was my fault the initial preparation was incorrect....

Ken

 

[charles007]

Best to walk away Ken,,, his years in dental school were a waste and will never learn how to prep from a tech..
In my 40+ years of seeing the worst and the best, never had a doc asking me to prep to the margin...... can't be done, and I couldn't sleep at night if I followed his directions...
This doc needs to be reported and locked up.