NADL Cautions About Sources of Implants

Posted on August 31, 2015

Tallahassee, Fla. – The dental implant and prosthetic market in the US is projected to reach $6.4 billion in 2018, according the American Academy of Implant Dentistry. More than 30 million Americans are missing all their teeth in one or both jaws and require an implant procedure. With the increasing demand for dental implants, the National Association of Dental Laboratories (NADL) created the “What’s In Your Mouth?” campaign to inform dentists about what they can do to ensure quality restorations for their patients.

When a patient goes to the dentist and receives a treatment plan for implants, he or she might assume their dentist creates his or her restorations. However, because implants and other dental restorations are typically created in dental laboratories, it is difficult for dentists to know how the implant was produced, the condition of the laboratory, or what materials were used. 

“No matter how well trained a dentist is or how clean his or her dental instruments are, the patient could still suffer health complications if the implant contains grey-market materials,” says Gary Iocco, co-chair of the NADL Public Awareness Committee.

According to a 2014 NADL Materials and Equipment Survey, more than 85 percent of dental laboratories provide custom milled implant abutments for dentists. According to the U.S. International Trade Commission, nearly 38 percent of dental restoration units are made overseas by foreign dental laboratories. Additionally, domestic laboratories remain unregulated in more than 40 states by their respective state boards of dentistry.

As implant demand continues to rise, NADL’s “What’s In Your Mouth?” initiative suggests 5 ways dentists can ensure their patients are getting the quality restorations they deserve.

1. Dentists can find out if their state requires minimum dental laboratory standards here.

Most state dental practice acts do not regulate or set standards for operation for dental laboratories or dental technicians. It is important that dentists seek to work with individuals and companies that have voluntarily achieved “third-party verification” of their skills, knowledge and operating standards.

2. Dentists can find a Certified Dental Technician to work with here. (Click on the CDT logo under “Show”)

The ability of dentists to deliver a high standard of care in restorative and cosmetic dentistry is enhanced by working with a formally educated, trained, and/or Certified Dental Technician. Dental technicians bring considerable experience and subject matter expertise in the areas of dental materials, technology utilization, shade verification, and implant dentistry. Dental technicians are true partners in helping dentists grow their practice. Dental technicians, although generally operating behind the scenes in the oral health team, are a crucial part of ensuring the delivery of quality dental care.

3. Dentists can find a Certified Dental Laboratory to work with here, and find a Dental Appliance Manufacturers Audit System (DAMAS) accredited laboratory here.

Dental restorations increasingly are being imported from countries like China, India, and Vietnam. Depending on the country, those dental laboratories might not be subject to the same scrutiny that domestic laboratories receive from the US Food and Drug Administration. It is crucial for dentists to be informed of where exactly they are getting their restorations from.

The DAMAS specifications provide a clear-cut process for improving documentation in every facet of laboratory operations including: dental prescriptions/work authorizations; patient contact materials; subcontractor/supplier agreements; material and equipment purchases; employee training; maintenance and calibration of equipment; labeling; customer complaints; and material traceability. To ensure product quality and foster a professional industry relative to quality assurance, NADL offers this system as a resource to dental laboratories.

4. Dentists can stay up-to-date on legislative updates here.

Staying informed will help dentists and their staff become a go-to source for patients’ restoration questions.

5. If dentists are working with a CDT and CDL, they should inform their patients that they are receiving quality dental restorations. 

Patients have a right to know. Patients should have access to their personal dental records that outline the patient contact materials that are used in their restorations and also in what country such finished restorations are manufactured. Patients should be aware that approximately 25 percent of domestic dental laboratory sales and 38 percent of actual restorations are manufactured overseas. There are 42 countries that currently have foreign dental laboratories registered with the US Food and Drug Administration.

For information on the campaign, please visit the website:

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