Remakes and repairs industry Standards

[Steve Killian CDT]

I'm looking for the statistcal average on remakes and the average on repairs. Remakes being defined as a unit that comes back and you have to start over completely. A repair is a simple alteration or addition to the existing restoration. What is available in published research or what averages do you find in your labs?

 

[Travis]

Hi Steve, welcome to DLN.

This sounds like a LMT article.

I moved this into the removable section.

 

[Mark Jackson]

I'm looking for the statistcal average on remakes and the average on repairs. Remakes being defined as a unit that comes back and you have to start over completely. A repair is a simple alteration or addition to the existing restoration. What is available in published research or what averages do you find in your labs?

This is a hotly debated subject, but it is widely believed that the AVERAGE remake percentage is about 2.5-3% external, 3-4% over all. There are so many dynamics beyond our control that are just hard to filter out every one.

I budget 5%, and therefore use that as the cutoff for any dentist or lab client, and likewise use it as the cutt off for our DAMAS protocol as you might remember from my presentation at Vision 21

 

[NicelyMKV]

This is a hotly debated subject, but it is widely believed that the AVERAGE remake percentage is about 2.5-3% external, 3-4% over all. There are so many dynamics beyond our control that are just hard to filter out every one.

I budget 5%, and therefore use that as the cutoff for any dentist or lab client, and likewise use it as the cutt off for our DAMAS protocol as you might remember from my presentation at Vision 21

Mark, when you say that 5% is your cutoff, what exactly do you do at that point? I am dealing with one account with a 10% as opposed to my average 1 to 1.5% with all the rest.

 

[Labwa]

CUT THEM OFF haha

 

[stevo]

600 units per year if I had 6 complete remakes that would equate to 1% but what you may have is some articulated grind ins or removing the anterior teeth because the patient was unhappy with the appearance or a need to open or close the vertical dimension, at a guess I would have 2to 3% alteration to dentures after completion.

I am a dental Prosthetist working directly with the public so my need to correct any faults is very high as word of mouth is your best form of advertising

 

[AJEL]

Steve I believe the difference is also with the type of lab. C&B a full remake is probably a little higher, mostly for poor acceptance of impressions & shading, & much larger volume.
In 2011 I had 9 remakes all from 2 DDS & I had asked for new impressions and should have stuck to my guns, they are partners and the cases all came in in 1 month. I only collected when they were given a court summons and I got the court filing fee because of my lab contract. I have had DDS ask me to not charge when the patient changes mind on shade but a set of teeth is a set of teeth (they got charged).

This year 2012 I picked up a new DDS I asked for a new model (it just didn't look quite right),he told me he makes enough on a denture he doesn't mind a reline. What he ment was he didn't mind asking for a free reline because the denture was loose. Ira S is no longer an account. I really need to work on my communication skills.
So what I am saying even in this economy cut the bad one loose as quickly as possible. I'm not as good a businessperson as some here but I can at least fire a problem before it becomes to expensive.
I'm a 1 man basement removable lab but I try to keep many DDS as customers, I know some C&B who have 1 or 3 only and that can make things very difficult. I took an accounting course in that the instructor said have a customer base not a base of 1 customer.

 

[denturist-student]

@Stevo...My instructors tell me that the patients should have a spouse with them when the try in is done. Already this year several of the student cases were not received well by a spouse who did not attend the try in appointment. ON instructor advised me whent hat situation arises then refund the deposit money and take back the denture case and save it for a while...He said you would be surprised how many came back and wanted his original dentures again.
I would encourage a close relative to attend at the try in for an esthetic confirmation....however that is rarely done....Usually the patient is perfectly happy until the spouse makes a trite comment...funny world hey?...I guess the money refunded usually which comes back is far better and less expensive than a tribunal hearing....Take care.....DS

 

[DentureDude]

i once had a doc that didn't seem to care about the bite at all? he was happy to just get it close. in almost every full two case, after it was processed and finished he would send it back with a wax bite and ask if i could cut all the teeth off in a horseshoe,.. reset it with wax where i made the cut and send it back for a new try in.. and every stinking time it was then all good and ready for a new finish. at first i was really concerned because it seemed like a remake?.. but when i spoke with him he assured me not to worry about it. "thats just how i like to do it".. this happend so often i ended up buying a small lapidary band saw for the lab. i set it up with a very small and thin diamond blade just so i could quickly and efficiently slice this guys dentures horizontally in half after they were all done? .. just when you think you have seen it all? popcorn


and yes,
i made al least an extra benjamin on every case.

 

[pingvin]

@Stevo...My instructors tell me that the patients should have a spouse with them when the try in is done.

I agree it is an important factor!

I am one man basement lab as well, I would say my remake percentage is about 0.1 %, but I ask many times for another impression, I would say in about 5-7% of cases. In about 3-5% of cases I ask for another bite.

 

[droberts]

Less than .025% With good communication between the doctor and lab, avoids alot of remakes. I suggest to all offices that the doctor takes the impression and looks it before it leaves the office. To put in bluntly, the doctor is not only wasting my time when they have to re-impress, its co$ting them their time. Us techs have to be on the same level as the doctor to understand the protocol for sucessful cases.

 

[HDL Owner]

Never kept an accurate record of remakes, my mistake as a small lab! I do know if I see;Hazel Stoltzfus name twice in a month-must be a remake and the Dr get a personal visit! What was wrong with #1? return it and I will gladly remake #2 free of charge. No Return no new denture! Even K-Mart asks you to return the old one first. Stops re-makes LOL Ill fitting denture? NOT my problem=Your impression/model! Change shade? Hay Dr-I am a house painter, you requested green you got green now you want white? 5,000$ to repaint, same as orginal price. I did as you requested Not my problem you don't like Pea soup house!!!!!!!!!!!!!!!!!!!!!! Deceased patient is different, I allow full refund!

 

[paulg100]

Deceased patient is different, I allow full refund!

how is that your problem, surely doc should claim the fee from the dead persons estate.

 

[Mark Jackson]

Less than .025%

Dan, I love you, but I have to call BS on this.

Just the simple fact that we have variables in impression materials, bad models, bad temporaries, poorly chosen shades, patients who arbitrarily don't like something for no practical reason, materials exposed to evironmental conditions such as heat and cold during shipping, errors during infection control, or impressions that are poured too soon or too late, temporaries that fall off, bad bites, people who bleach their teeth during the time the crown is being made, teeth that move, pulps that erupt after prepping, buildups or preps that crumble or fail requiring RCT, material failures such as chipping or fractures......it goes on and on.

The only way a lab has .025% remakes, is when a dentist will seat ANYTHING that rolls in the door. Statistically it's impossible.

 

[IVY]

Even when I worked in house with highly skilled prosthodontists doing 90% fixed we were not at 0.25%. One of the prosthodontists once said (I think quoted) there are 250 things that can go wrong or effect the outcome of a prosthesis from the time the patient hits the chair to delivery. The good ones work with you on this and try to make remakes and adjustments minimal. It is our reality, the mouth is not a static environment. We can only try to keep our techniques and models as consistantly similiar as possible.

 

[pingvin]

I on the other had believe that 0.25 is possible (if we are talking about remakes). If dental tech checks and refuses all questionable impressions, if he sees patient and is there with almost all phases, if he helps with choosing a color, ... I would say it is possible.

 

[Mark Jackson]

Mark, when you say that 5% is your cutoff, what exactly do you do at that point? I am dealing with one account with a 10% as opposed to my average 1 to 1.5% with all the rest.

What is your profit margin?

If it's 5%, you do 19 units at NO PROFIT to pay for ONE remake! I have, over the 31 years I've been in business grown comfortable with the fact that we CANNOT expect to have less than about 3% remakes. I build 5% into my operating and production budgets, and if a dentist or lab client is running more than 5% he goes on "double secret probation" and we watch them like a hawk and document everything.

Depending on the size of the account and their product mix, we will make every effort to rehabilitate them, and if that doesn't work, we refer them out to either one of the local labs or mail order labs we know and wish them well.

If we have a particular product that has more than 5% remakes, we put that PRODUCT on probabtion and call in the manufacturer, we take a serious look at our protocol, and we decide if we should just drop that product off our menu.

Apnea devices were the last product to get the ax.

 

[IVY]

Recently in Ontario you need proper physicians script before fabricating a sleep apnea appliance (then dentists script) because of the real risk of fatality. Some times the patient needs a CPAP not a cheap double suck down or even expensive snore guard.
IV

 

[Mark Jackson]

I on the other had believe that 0.25 is possible (if we are talking about remakes). If dental tech checks and refuses all questionable impressions, if he sees patient and is there with almost all phases, if he helps with choosing a color, ... I would say it is possible.

Guess you don't do implants. 97% success rate according to the ICOI, and that's POST RESTORATIVE.

I'm sure there are a bunch of miracle working technicians here who don't have overly picky patients, and never make mistakes.

I check my pride and ego at the door.

 

[Steve Killian CDT]

Hi Steve, welcome to DLN.

This sounds like a LMT article.

I moved this into the removable section.

Travis,

We are mostly C&B so I really wanted the answeres to be weighted that way. C&B remake percentages could be higher than removable. That being said it would be best to seperate the two. Now that you've placed this in removable I won't get the answers I was looking for with C&B.

Steve Killian