Built my lab. Got acquired. Building another, but then what?

[Chad Gardner]

I agree. Working from home sounds good but I’d eventually pull my hair out.

 

[JMN]

I feel like I’m defending or justifying my use of technology. I was just trying to state that I see the need for highly skilled designers in the future. That’s all. And I could be wrong!!!

Dude, you're cool. All is well.

You likely would have difficulty in believing the truly unsurpassed gall of dozens or hindreds of docs a year that buy a bunch of kit, then ask their lab or us here how to use it and even where and how to hook it all together.

Sadly we've gotten a bit kneejerk and at times nearly anaphalactic about it.

In this case it was friendly fire.

Duck! Incomming!

 

[Chad Gardner]

I can believe that. The DDS diploma comes with a huge ego at N/C

 

[charles007]

I can believe that. The DDS diploma comes with a huge ego at N/C

You earned 5 Stars for that quote.....
Drinks on me if we ever meet !

 

[Chad Gardner]

It’s true. I spent a day at my lab years ago while my truck was being worked on and was blown away by the teepee preps and DDSs calling to complain “the crown keeps coming off.”
Really? With 30° taper, I wonder why?
I got on the phone with one guy the lab owner had had enough of. “The denture won’t stay in and I took the impression with VPS” was his complaint on an ICUD. I saw the impression he’d sent. I said it’s not VPS, it’s Alginot in a plastic tray. And it doesn’t even reach #15, much less the hamular notch. You do realize that’s your retention, right?”
He actually gave up dentures and the owner says he’s a solid C&B client now!

 

[JMN]

It’s true. I spent a day at my lab years ago while my truck was being worked on and was blown away by the teepee preps and DDSs calling to complain “the crown keeps coming off.”
Really? With 30° taper, I wonder why?
I got on the phone with one guy the lab owner had had enough of. “The denture won’t stay in and I took the impression with VPS” was his complaint on an ICUD. I saw the impression he’d sent. I said it’s not VPS, it’s Alginot in a plastic tray. And it doesn’t even reach #15, much less the hamular notch. You do realize that’s your retention, right?”
He actually gave up dentures and the owner says he’s a solid C&B client now!

You may like our "Please, stop practicing" file.

Facepalm cases

so lets start a thread and fill it with images of cases (with no names) of some of your most Facepalm worthy disasters. i'll start... got this one this AM in my Purolator. he wanted a 5 unit Full contour Zirconia bridge. Uploaded with ImageShack.us Uploaded with...

dentallabnetwork.com

 

[Chad Gardner]

WOW! Thank you!

 

[JMN]

WOW! Thank you!

You may change your mind after about 3 pages.

 

[Chad Gardner]

Dang that kept me up late and only 10 pages. I see a few things I can explain but not justify.
1. Corporate dentistry...
2. CBCTs and a weekend course in implants
3. Some dental schools really suck
4. New grads want to get out and do big cases. I’ve had 3,associates quit bc I wouldn’t let them do big cases when their class II amalgams fractured routinely
5. Some DDSs JDGAF!!! We mixed up 2 FPDs and when we called the other guy, he had already delivered it. They were both 2nd bi to 2nd molar, but OPPOSITE SIDES!
6. Some DDSs graduates have no clue what they are doing. They think bonding will fix it
7. I see a lot of simple cases made complex by the DDS when a CUD would have worked.
8. Triple trays suck
9. Assistants are taking a bunch of final impressions!
But I feel better about the kissing direct resins i did today but hated the anatomy.
Yall are some creative SOBs!!!
Gnite guys.

 

[Chad Gardner]

10. Possibly aging DDSs don’t know how to use triple trays, VPS, etc.
11. Federal Health clinics: DDSs are nearly liability free and have no OH. I know many newer grads are skipping GPR & AEGD residencies and working in them for a “paid residency”
Idk. I’m just trying to wrap my brain around some of that crap. Unreal.

 

[rkm rdt]

Dang that kept me up late and only 10 pages. I see a few things I can explain but not justify.
1. Corporate dentistry...
2. CBCTs and a weekend course in implants
3. Some dental schools really suck
4. New grads want to get out and do big cases. I’ve had 3,associates quit bc I wouldn’t let them do big cases when their class II amalgams fractured routinely
5. Some DDSs JDGAF!!! We mixed up 2 FPDs and when we called the other guy, he had already delivered it. They were both 2nd bi to 2nd molar, but OPPOSITE SIDES!
6. Some DDSs graduates have no clue what they are doing. They think bonding will fix it
7. I see a lot of simple cases made complex by the DDS when a CUD would have worked.
8. Triple trays suck
9. Assistants are taking a bunch of final impressions!
But I feel better about the kissing direct resins i did today but hated the anatomy.
Yall are some creative SOBs!!!
Gnite guys.

I actually don't mind working with Drs that are open to improvement. I value the opportunity to not only help but to learn in the process. If we can both share the same desire without attitude then it can only be a winning combination that benefits the patient.

 

[Flipperlady]

I checked on liability and it’s not been established I.e. the laws are not up to date with the technology. Insurance company said they assumed it was on the person that mills and/or delivers. He’s no more liable than an assistant designing a CEREC in their opinion but it’s never been challenged in court.

As to getting a mill, I never said I was not ready but many other DDSs buy them w/o being ready. My wife is a CDT that does a lot of the work. I also have been Cerecing for 7 years and know inLab inside and out and am decent to good at Exocad but it’s just not worth my time when I can outsource the design so cheap. It’s paid for itself in tax savings alone. Wife rents the space from the practice and “bills” the practice whatever is needed to optimize tax savings. Totally legit as I was audited last year.
Her lab actually showed a net profit of $18k from doing work for local DDSs in a pinch. Charge $250/unit for 24 hour crown or FPDs. Amazing how many will prep a FPD w/o having a temp stent and will pay for a quick bridge so teeth don’t drift.
And I’ve discovered that the biggest barrier to treatment is not money, it’s time. When I say for example “I can do a FPD 6-11 today and eliminate your UPD” they jump on it. I prep & scan with the Omnicam, transfer with Cerec Connect, me or wife design and mill a PMMA real quick, check the esthetics and work out the occlusion, then make the final(s) with MIYO. The PMMA’s alone make it worth the $60k I have in it, as I can verify my margins, esthetics etc. and send to my lab for the final if we’re busy with kids ballgames or homework. I did an all on 5 lower 2 weeks ago with a total cost of ~$2k including implants, MUAs, everything. The milled guide was also my temp framework, milled from Trilor, 3D printed teeth with a slot for the Trilor (Cory Glen, DDS methods) and pink composite. I placed the implants guided, put the MUAs and chimneys on through the guide holes, picked up with Stellar DC, cemented the PMMA’s on, cut off the pin arms and chimneys, polished and delivered in 68 minutes.
I learned about him through another DDS with a 5 axis while complaining about spending too much time designing. I’ve never met him but just speak via email, phone or text. HIPPA email accounts or Dropboxes are cheap and I already had both.
I know personally 9 DDSs with at least one 5 axis and a few others in the process of buying. A Medit Scanner, Roland 52D, MIYO and Austromat 674i is a lot cheaper than a Cerec, much more versatile and removes the all so powerful time barrier. I’m also in a very low income area so it allows me to do charity work and not lose my shirt. I crowned 28 teeth on a 19 year old with enamel hypoplasia and Zahn donated the block and I donated my time, mill and cement. I do a lot of these cases pro bono as I was raised very poor but feel blessed so I try to give back as much as I can
One guy bought a used scanner and Roland and only does PMMA’s, then sends all final scans to his lab. Im rambling but I see many more DDSs in need of in house techs or designers.

The liability has always been on the dentist as they are the ones who accept the work and have the license to prescribe. I've peeked at the Exocad and honestly looks like a weekend course to learn and a learning curve of a few weeks to perfect, the downside is the cost to use. Digital dentures atm look awful, and will probably continue to look like this until the removable techs with years of experience are on board. I think I was one of the first people making microwave dentures years ago, from a course taught by Dr Shipman Jr, Dr. Rudd, and the other big name escapes me now. At the time I thought microwave was really cool, still do, digital printing/milling is just another form of processing and an inferior one atm. That said with strange viruses out there, manufacturers making the hard sell to dentists, and cutting off lab supplies to force labs to convert ;-p, I think more dentists will be interested, and looks cool as well, I'm taking a hard look at it.

 

[JMN]

The liability has always been on the dentist as they are the ones who accept the work and have the license to prescribe. I've peeked at the Exocad and honestly looks like a weekend course to learn and a learning curve of a few weeks to perfect, the downside is the cost to use. Digital dentures atm look awful, and will probably continue to look like this until the removable techs with years of experience are on board. I think I was one of the first people making microwave dentures years ago, from a course taught by Dr Shipman Jr, Dr. Rudd, and the other big name escapes me now. At the time I thought microwave was really cool, still do, digital printing/milling is just another form of processing and an inferior one atm. That said with strange viruses out there, manufacturers making the hard sell to dentists, and cutting off lab supplies to force labs to convert ;-p, I think more dentists will be interested, and looks cool as well, I'm taking a hard look at it.

The biggest issue is material science has not caught up with the mechanisms.

Glidewell's pumping them out and I've fixed a few already that were cracked around 80% of the arch where the teeth were bonded in. I suspect that we will find tye bonding to be a far more curcial stage than is currently said. If tue bond is not uniform not only through the arch but in each pocket force is beong focused on/by the areas that do have bonding between the parts.

That's my $.02 on current state from about a dozen Glidewell printed ones I've held.
And I know if they are doing it that way, it's happening with in-office labs; that doesn't doom the technology, just that they seem to be very good at finding failure points.

 

[Flipperlady]

The biggest issue is material science has not caught up with the mechanisms.

Glidewell's pumping them out and I've fixed a few already that were cracked around 80% of the arch where the teeth were bonded in. I suspect that we will find tye bonding to be a far more curcial stage than is currently said. If tue bond is not uniform not only through the arch but in each pocket force is beong focused on/by the areas that do have bonding between the parts.

That's my $.02 on current state from about a dozen Glidewell printed ones I've held.
And I know if they are doing it that way, it's happening with in-office labs; that doesn't doom the technology, just that they seem to be very good at finding failure points.

The technology is bad and rushed, it can be perfected, however the large corps like DPly cutting off our lab supplies will not make the techs with the knowledge to make it work want to be part of the "revolution". Gwell has their own business model, best to refer their repairs back to them if I were you. I'm at a stage in my career looking for change, have been for about 5 years. I could see myself working for a dentist designing dentures virtually, I just follow the prescription, the dentist has to use their conscience after that.

 

[David Lesh]

I have business proposal for you. Need help with marketing new product in dental industry

What's the new product?

 

[Macaroni1116]

Your story as an entrepreneur is extremely exciting! You became an almost overnight success without having to go to graduate school like most millennials are brainwashed into thinking. Thank you for sharing.