Table of Contents

Continuing Education
Case Report
Research Update

Compendium

April 2014, Volume 35, Issue 4
Published by AEGIS Communications

“Prospecting” a Profitable Practice: How Precious Metals Can Yield a Rewarding Return

Tom Mappin

In addition to offering patients quality care, dentists are in practice to earn a living and, therefore, make a profit. There are time-saving efforts through which they can maximize the efficiency of their dental practices without sacrificing patient care or the quality of restorative work. Of course, to maximize revenue, dentists need a base of happy patients; when care and restoration quality are maintained at high levels, patients are more likely to be satisfied, and, consequently, refer others to the practice. An additional means by which dentists who offer restorative solutions using precious metal can benefit their practice is by collecting the scrap of such metals. Because of their consistent value, all precious metals are worthy of collection.

Still a Place for Gold

Dentists have a myriad of material choices available for reconstructive dentistry, and in recent years the industry has witnessed the progression of dental technology into the digital age. Computer design and manufacturing paired with intraoral scanners in the dentists’ hands and patients’ mouths has transformed the art of dentistry. The preferred material choice in many situations is now a metal-free, natural-looking crown or bridge. Prosthetics that are CAD/CAM milled out of lithium disilicate and zirconia are strong, esthetically pleasing, and durable. Also, the precision with which they are milled allows for better fitting restorations than were ever thought possible using traditional analog techniques.

Still, sometimes the most appropriate restorative solution includes the use of precious metals. From gold crowns and inlays, to substructures for porcelain-fused-to-metal (PFM) restorations, and from implant abutments to precision attachments, precious metals can be used to achieve optimum results when other materials may produce less than ideal outcomes.

Many times gold is the best restorative material option. It is true that in recent years the costs of dental alloys have increased beyond a price point that makes them profitable to prescribe. Additionally, costs associated with fabricating and manufacturing a gold crown using the lost-wax technique also factor into patients choosing other options. Moreover, global market price fluctuations also contribute to dental alloys being used less consistently.

However, gold restorations still have their place in dentistry, as there continues to be a demand for full-contour gold crowns and bridges. A tried-and-true treatment modality, the track record for gold restorations remains unmatched in reliability, and now with the emergence of milled full-contour noble gold alloy restorations, this option is returning to the realm of affordability once again. Gold restorations offer precision fit and accurate marginal integrity, and the accuracy achieved with any milled material, including gold, is clearly superior to the results of using the lost-wax technique.

Metal Scrap Collection Guidelines

It is hard to understand, particularly in struggling economic times, why many dentists who prescribe restorations fabricated from precious metal fail to collect their surplus precious metal scrap. In addition to providing environmental benefits, collecting and recycling precious scrap metals in a dental practice turns into positive cash flow. Here are some tips to help a dental office properly collect precious metals for the greatest return:

• Collect any crown and bridge restoration containing metal, even if there is some uncertainty of its makeup. These include: gold crowns, PFMs, implant frameworks, and unused dental alloys.

• Collect any unused amalgam (popcorn amalgam) separately from the other scrap. In the refining process, the mercury is actually distilled away from the other elements, which never reach their melting points. For this reason, any amalgam with tissue, tooth, or root should be placed in a biohazard bin. Organics like these can absorb mercury like a sponge, then emit mercury gas during smelting of the other metals.

• Collect gold partial dentures (though rare, they still exist).

Selecting a Professional Refiner

Dentists can utilize professional refiners who specialize in the process of refining dental scrap. They should know that not all refiners pay on all precious metals. It is important to consider a refiner that specializes in the actual process of precious metal refining, because the separation of platinum group metals prevalent in today’s dental alloys requires special equipment and standardized procedures. The assay of material should scientifically determine the exact composition of all precious metals to parts per million, and dentists should receive payment at reasonable market rates for all of those metals. Also, by recycling on a regular schedule, patterns will be revealed that will help determine approximately what amount to expect from each return.

Precious metals can be a vital contributor to dental practice profitability. While providing the most efficient and economical services to their patients, dentists who redeem their scrap metals can also be modern-day “prospectors.” It’s easy, smart, and profitable.

ABOUT THE AUTHOR

Tom Mappin
Vice President of Operations, Atlantic Precious Metal Refining, Pittsburgh, Pennsylvania