Guidelines

The Guidelines for Dentist/Dental Laboratory Relations were first established in 1987 in cooperative effort between the Illinois State Dental Society and the Illinois Dental Laboratory Association. These Guidelines are voluntary for members of both organizations and we hope they will be useful to assist dentists and laboratories in further understanding their respective responsibilities.

The Dentist: The Dentist shall provide a properly prepared and signed prescription to the laboratory or technician according the to Illinois Dental Practice Act. The prescription shall detail the work which is to be performed, describe the materials which are to be used and be written in a clear and understandable fashion. A duplicate copy of the prescription must be retained for 3 years. The Dentist should provide the Laboratory/Technician with accurate impressions, casts, bite registrations, and or mounted casts. The Dentist should identify the margins, postdate, borders, the areas to be relieved or omitted, and design partials on all cases. The Dentist should furnish a shade (color) description, photograph, drawing, or shade button which matches the patient’s teeth most closely. If desired, the Dentist may also send the patient, with a written prescription, to the Laboratory/Technician for the purpose of directly determining the shade selection. The Dentist should provide verbal or written approval to proceed with a laboratory procedure, or make any appropriate change(s) as the Dentist deems necessary, when notified by a Laboratory/Technician that a case may have a questionable area with respect to paragraphs 2-4. The Dentist should alert the Laboratory/Technician about the patient’s health status if a serious communicable disease exists or is suspected. In such case, however, the Dentist is not required to identify the patient by name but has the option of using a patient identification number. If a number is used, the patient’s name must be written on the duplicate copy of the prescription retained by the Dentist. The Dentist should thoroughly clean all blood and saliva from all materials used in the mouth (e.g. impression materials, occlusal registrations, intra-oral appliances, etc.) and should disinfect these items according to ADA recommendations before sending them to the Laboratory/Technician. Any appliance returned from the Laboratory/Technician should be disinfected, washed and rinsed before it is placed in the patient’s mouth. Care should be taken that all materials are placed in an appropriate container provided by either the laboratory or the dentist and should be packed properly to prevent breakage. Work to be shipped to a Laboratory/Technician should be packaged and transported according to current infection control standards. The Dentist may, when it is mutually advantageous for the patient and Dentist, and when it is specified in the prescription, have the patient deliver and/or pick up an appliance directly from a Laboratory/Technician provided the patient returns to the Dentist’s office to have the appliance evaluated, placed, and to have any necessary adjustments made. In the event a patient drops off or picks up an appliance, laboratory personnel shall not engage in any activity which involve the trying on or fitting of appliances with patients, or any other activity with patients, with the exception of permitted shade taking as described earlier. The Dentist should return all casts, registrations and appliances to the Laboratory/Technician intact and structurally undamaged if an appliance does not fit properly or if the shade selection is incorrect.

The Laboratory/Technician: The Laboratory/Technician should fabricate dental appliances which follow the guidelines set forth in the prescription provided by the Dentist. The appliances should fit properly on the casts and mountings provided to the Dentist. Original prescriptions must be retained for 3 years. When a laboratory provides prescription forms to a dentist, the forms should contain the name of the laboratory, space for instructions, expected delivery date, patient name, signature line for the dentist, license number and other information requested by the laboratory. The Laboratory/Technician should return the case to the Dentist to check the mounting if the technician has set the bite and there is any question of its accuracy or the technician questions the accuracy of the bite registrations furnished by the Dentist. The Laboratory/Technician should match the shade which was described in the original instructions, within the limitations of the materials generally available to the profession. Laboratory personnel shall not engage in the removal or insertion of any appliance unless attended by the dentist. The Laboratory/Technician should notify the Dentist in two (2) working days after receipt of the case, if there is a reason for not proceeding with the work. Any changes or additions to the prescription must be agreed to by the dentist and must be initialed by authorized laboratory personnel. A copy of any changes made shall be sent to the dentist upon completion of the case. After acceptance of the prescription, the Laboratory/Technician should fabricate and return the appliances in a timely manner in accordance with the custom in the profession. It a prescription is not going to be accepted, the Laboratory/Technician should return the work in a timely manner and include a reason for denial. The Laboratory should follow all OSHA regulations with its employees with respect to personal protective equipment and disinfection of appliances and materials. All materials should be checked for breakage and immediately reported if found. The Laboratory/Technician should not be held responsible for the patient’s toxic reactions to materials that are prescribed by the Dentist, but should inform the Dentist of the materials present in the case. The Laboratory/Technician should clean and disinfect (according to ADA recommendations) all incoming items for the Dentist’s office (e.g. impressions, occlusal registrations, intra-oral appliances, etc.) and these items should be cleaned and disinfected when they are returned to the Dentist. All appliances and other laboratory materials which are returned to the Dentist should be placed in an appropriate container, packed properly to prevent breakage, and transported according to current OSHA standards. The Laboratory/Technician shall inform the Dentist of any subcontracting Laboratory/Technician employed for preparation of the case according to the Illinois Dental Practice Act. The Laboratory/Technician shall furnish a written order to the dental laboratory which has been engaged to perform some or all of the services on the original prescription. Laboratory personnel shall not engage in the removal or insertion of any implant related case according to the Dental Practice Act. If a dentist is present, a qualified laboratory technician may assist the dentist in the placement or removal of the appliance. The Laboratory/Technician shall not bill the patient directly under any circumstances. Charges made by the laboratory to the dentist are strictly confidential, and laboratory personnel should not discuss or divulge these charges to the patient.