The Legality of Unilateral Partials

[ultrasport]

I run a Crown & Bridge lab but one of my customers asked me to make what he's calling a flipper but with wrought arm clasps. No problem making the
item but it is a 3 tooth unilateral design. I thought it must have in this case an upper a palatal connector going to the opposite side to avoid the patient from swallowing the partial if it gets dislodged.
Are unilateral partials illegal to make? I'm in NJ maybe different states have different laws.
Can anyone shed some light on this before I proceed.
Thanks

 

[Mark Jackson]

I run a Crown & Bridge lab but one of my customers asked me to make what he's calling a flipper but with wrought arm clasps. No problem making the
item but it is a 3 tooth unilateral design. I thought it must have in this case an upper a palatal connector going to the opposite side to avoid the patient from swallowing the partial if it gets dislodged.
Are unilateral partials illegal to make? I'm in NJ maybe different states have different laws.
Can anyone shed some light on this before I proceed.
Thanks

There is no law against them in ANY state, but there IS a liability issue. This is where it's a good idea to have a contract with your clients that limits your liability. That being said, no contract will protect you from being hauled into court anyway, and if the plaintiff suspects you have any money at all, you can expect to be served if something goes wrong. My contract is over 14,000 words long but nothing makes you nusiance proof.

Sometimes, it's just smarter to pass on a case that you know may be a libility. The $100 worth of sales isn't going to put you out of business.

That contract should be in place anyway, because everything you make has an aspiration risk!



BTW, that is a bridge and a bra with underwire if you were wondering

 

[CShof]

I made one not too long ago and I talked the doctor into one made completely out of versacryl with no wire clasps. I felt a little safer with that approach. I'll bet you could make one out of valplast too.

I know you said you're a c&b lab so I'm not sure if you'd have that stuff. You could always farm this one out to another lab.

 

[araucaria]

I made one not too long ago and I talked the doctor into one made completely out of versacryl with no wire clasps. I felt a little safer with that approach. I'll bet you could make one out of valplast too.

I know you said you're a c&b lab so I'm not sure if you'd have that stuff. You could always farm this one out to another lab.

With metalwork involved there's always the chance of easy location in the event of a recovery operation. Also clasps are more likely to snag the internal tissues.
This is a very rare occurance but it can happen, so always consider the possibility when designing.

 

[kcdt]

Folks, it is possible to swallow anything. Mark has a valid point.

 

[rkm rdt]

Folks, it is possible to swallow anything. Mark has a valid point.

Yes after reading some recent posts on here,I would add...

...hook lie and sinker! :fish2::fish:

 

[Mark Jackson]

Folks, it is possible to swallow anything. Mark has a valid point.

When I was working on the ScanAcryl material for CT Scans, we were contacted by the Chief or Thorasic Surgery from Jewish Hospital in Long Island who has had to retreive enough aspirated dental material that he was working to get a law passed to make ALL dental material radiopaque so that he could retrieve them without doing exploratory surgery to find them.

One patient was hosptalized for 50 days before he passed away. I never heard what the outcome was, but in a case like that, I am fairly confident the family drug in anyone who could be even remotely responsible. If you own a business, it's just good practice to limit your liability when ever possible. That means contractually, and in soime cases just passing on things that we know might be a problem.

Anything that goes in the mouth could be aspirated, and anything removable is even MORE likely to be a problem, and as an attorney for a patient, I would definately question whether the device was designed correctly, and that falls squarely back in the lap of the technician, especially of the case was done without design directions from the dentist.

 

[rkm rdt]

Is this why every dental lab should have a supervising CDT on the premises and every state should require it?

 

[Mark Jackson]

Is this why every dental lab should have a supervising CDT on the premises and every state should require it?

One reason a credentialed tech should own the lab, that's for sure.

 

[hydent]

Acetal resin is by far in my opinion the best choice for unilaterals I lost a molar when I was younger I ware a unilateral to maintain space in that area. This s.o.b. is so retentive I don't see how it can come out without trying I chew gum with it without even coming close to coming out. Acetal resin can engage 2/3 more undercut than cast chrome and they look 100 times better with much more retention. It has worked so well I have found myself putting off the implant in that area.

 

[dmonwaxa]

Is this why every dental lab should have a supervising CDT on the premises and every state should require it?

Yes rkm, so liability can be passed along to the CDT...popcornpopcorn

I was under the impression that if a appliance is delivered its becomes the providers liability, what are the limits of liability in absence of a prescribed design?

 

[Mark Jackson]

Yes rkm, so liability can be passed along to the CDT...popcornpopcorn

I was under the impression that if a appliance is delivered its becomes the providers liability, what are the limits of liability in absence of a prescribed design?

This is why in other posts I have repeatedly stated that the labs should be registered and only competant, credentialled techncians be qualified to bring a product to market. The dentists today have very little laboratory training, and getting less and less of it as time goes by.

They are no longer qualified to make that determination, and the way tort law is in the US, they have every incentive to drag everybody who touched the case into court. As you know, Lee Culp was sued by a patient last year.

I added professional liability to my policy three years ago, and I'm glad I did. Especially since what we are doing is so much more complex than it was just a short time ago.

 

[ultrasport]

First off having a CDT in or owning a lab in this situation means nothing. Making this unilateral device is strictly a business decision. I have aready rectified the situation and spoke to the Dr. about the liability if the device is swallowed. Without hesitation the Dr. agreed to have the patient back in for a new impression for a full acrylic palate. I failed to mention in my original thread the original model I recieved from the Dr. was a quadrant which forced the unilateral design if I was to proceed.

I think communication is the answer here not being a CDT.

By the way I hold both CDT as well as a MDT designation.

 

[Mark Jackson]

First off having a CDT in or owning a lab in this situation means nothing.I think communication is the answer here not being a CDT. By the way I hold both CDT as well as a MDT designation.

No, I think it has EVERYTHING to do with it. If you were not a skilled and experienced technician, you might have proceeded with the case, without pausing to think things through.

I bvelieve your training made you question the decision to proceed. Well done, and congratulations on your credentials!

 

[rkm rdt]

No, I think it has EVERYTHING to do with it. If you were not a skilled and experienced technician, you might have proceeded with the case, without pausing to think things through.

I bvelieve your training made you question the decision to proceed. Well done, and congratulations on your credentials!

Thankyou for finally making my point Mark!

It took you almost a month but you are finally getting the big picture.

Being an RDT/CDT is a professional responsibility recognized by your peers.Through proper educational training and peer reviewed guidelines you make responsible decisions that enhance not jeopardize the profession.

Sometimes those decisions are in conflict with your business decisions( like making a unilateral or using counterfeit products).
Being irresponsible risks losing your privilege to be licensed and to operate a lab.

I carry errors and omissions insurance which is mandatory in my area.I pay association fees and also RDT licensing and supervision fees which are very expensive.

Maybe its time to practice what you preach and become a CDT . You have to make the changes through your associations but I'm sure you know that by now.

 

[Mark Jackson]

Thankyou for finally making my point Mark!

It took you almost a month but you are finally getting the big picture.

Being an RDT/CDT is a professional responsibility recognized by your peers.I carry errors and omissions insurance which is mandatory in my area.I pay association fees and also RDT licensing and supervision fees which are very expensive.

Maybe its time to practice what you preach and become a CDT . You have to make the changes through your associations but I'm sure you know that by now.

I am a Registered Dental Technician. This is an internationally recognized credential. The CDT is not currently recognized outside the US, so technically, the RDT is more valuable to me at the moment.

We are in agreement 100%. I think it is very important.

 

[rkm rdt]

I am a Registered Dental Technician. This is an internationally recognized credential. The CDT is not currently recognized outside the US, so technically, the RDT is more valuable to me at the moment.

We are in agreement 100%. I think it is very important.

I can't speak for the rest of the world but your RDT would not be recognized in Canada.You would not be able to call yourself an RDT without applying for and passing an equivalency exam.

In fact according to the California Dental lab Association your " International"RDT is not even recognized in your own state.

So what you're really saying is that everyone else should be licensed first?

 

[DMC]

I agree. Enough soap-box lectures.


BTW, my unilaterials have a retrieval cord attached...like a tampon.

I'd go ValPlast. If you want it radiopaque, then throw a piece of metal in it somewhere. Or Zirconia. Or a BB.

 

[Mark Jackson]

I can't speak for the rest of the world but your RDT would not be recognized in Canada.You would not be able to call yourself an RDT without applying for and passing an equivalency exam.

In fact according to the California Dental lab Association your " International"RDT is not even recognized in your own state.

So what you're really saying is that everyone else should be licensed first?

I belive that in order to own and operate a dental lab, and to bring a SAFE product to market, you should have some kind of credential demonstrating your knowlege and experience. You are entitled to your own opinion and I'm intitled to mine. So tell me about your lab.

You seem so hell bent on attacking my business model, what's yours?

 

[rkm rdt]

'You seem so hell bent on attacking my business model, what's yours? "

I'm not attacking your business model,I'm trying to find out if you are someone I would like to do business with.

I placed the order for my scanner this morning.