A note from Dr. Mn: I feel that a lot of people have a negative opinion about dental outsourcing, and I think their opinions are not based on the truth. I run an outsourcing business and I have a dental lab in China. I work in the lab in China every day, so I feel I know the lab side very well. I would like to share some firsthand information with readers and let them form an opinion based on the real situation.
What kind of crown is a good crown for the patient and dentist? As a dentist, my answer is, “A high-quality but low-cost crown made with the right material that is delivered to me on time.” There is no doubt that any lab that can provide these kinds of products will win the game. I don’t think any local lab or outsourcing lab can meet those four standards alone — quality, material, price, and timing.
Quality
I rad a comment in an online forum that said the crown from China is substandard. I don’t think that is a fair assessment. A standard crown in one country might be considered substandard in another country. For example, most European dentists want the crown to be individual. This means they want crack lines and discoloration on the crown. However, most of my U.S. clients only want the shade to match the shade guide. A standard shade for the U.S. market might be substandard for Denmark.
I will not say that all outsourcing labs make high quality products, but I think the quality is at least ok. My porcelain buildup technician can build up to 30 units every day. This means she will build up around 1,000 units a month. Normally, China labs will have the most experienced technicians make overseas cases, and these are usually people who have been working in the lab for at least 10 years. Please calculate how many units they have done in 10 years. I do not believe the job from them is “substandard.”
There is also a reason that I am not confident enough to say that China technicians can make “high quality” jobs. Working as a dental technician is not as decent a job as it is in the Western world. Most of the dental technicians are people from poor families that cannot send them to college. This means they don’t have a dental education. They become educated when they begin working in the lab, but it is not a very systematic education. This prevents those technicians from becoming top technicians. This is the difference between the technicians in the Western world. Another reason is that in a Chinese lab, more than 10 technicians make a crown instead of just one technician. This enables each technician to be very good at a certain procedure (that is why a porcelain technician can build up 30 units each day), but this also makes the technicians unable to have an “overview” of a case. The wax-up technician will not make a design that will give the best space for the porcelain technician. I don’t think anyone can find a top technician to make all of their cases, even in the U.S.
Material
It has been said that there are labs that use fake material in China. I agree with this. There are also labs in China that use the right materials. My lab used to buy alloy from a Chinese supplier. This demonstrates that it has no nickel inside, but my European clients tested the crown and it showed it had nickel inside. So I changed to the American brand Argen and bought it in China. Then I heard there is a fake Argen alloy in China, so I imported alloy from Argen in the U.S. directly. The price for NP Argen alloy is around $150 (U.S. dollars) per 1,000 grams. If I buy Chinese nickel alloy, it will cost me around $80 (U.S. dollars) per 1,000 grams. I would save money on each crown if I choose to use the fake material instead of right material, but that would be too much of a risk for me.
I can tell you that the cost of material for each crown is less than $5. The material is exactly the same as the material of the crown made in U.S.
Price
I charge my clients $23 U.S. dollars for a PFM crown. As I explained, the material cost for a crown is less than $5. What about the labor cost? I pay $1 for each unit to my porcelain technician. I also pay for each procedure from modeling to final control. The labor cost for each crown is less than $10. I pay shipping one way, and that costs me $5 each unit. The rest is my profit. The profit for PD denture and full zirconia crown is higher. You might say the profit is not rewarding. If I can make 10,000 units a month, it will be a decent profit. Anyway, I live in China, where everything is cheap.
Timing
The door-to-door turnaround time for an outsourcing lab will be around five to seven working days, depending on which country it is sent to and in which part of China the lab is located. A lab in a coastal area of China will have a better turnaround time than a lab in western China. My lab is in western China, and the turnaround time is six working days for the U.S. and five working days for Europe.
The problem for an outsourcing lab comes when the case needs some adjustment. It takes a very long time to send the crown back to China for minor adjustments. An outsourcing lab cannot compete with a local lab on this.
I don’t know why so many people are so afraid of an outsourcing dental lab. Why not combine the advantage of local and outsourcing dental labs together? If a local lab can outsource cases, then make the adjustments locally, how will that benefit the dental office? It will result in a high quality but low cost crown made with the right material, delivered to me on time.
Dr. Lv Min is a dentist in Chengdu, China. Dr. Min pursued a residency in dentistry for one year before earning his dental degree five years ago. Upon receiving his degree, he began to work full time in the Dental Outsourcing Dental Lab, where he has been for five years. He would like to change some people's negative perceptions about dental outsourcing.
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