SIC 8072
DENTAL LABORATORIES



This classification comprises establishments primarily engaged in making dentures, artificial teeth, and orthodontic appliances to order for the dental profession. Those establishments primarily engaged in manufacturing artificial teeth, except to order, are classified in SIC 3843: Dental Equipment and Supplies , and those providing dental x-ray laboratory services are classified in SIC 8071: Medical Laboratories .

NAICS Code(s)

339116 (Dental Laboratories)

Industry Snapshot

According to the U.S. Census Bureau, there were approximately 7,500 dental laboratories providing almost $3 billion worth of services in 1997. These businesses produced custom-made prosthetic appliances for the dental profession. By 1997, this fragmented industry employed roughly 41,000 people domestically. Entering the mid 1990s, the industry had been expected to experience some growth based on continuing "advances in dental techniques, increased cosmetic dentistry, and increased dental insurance coverage." Advances in preventive dental care, however, were also predicted to have a negative impact on the pace of that anticipated growth. In fact, the number of businesses declined during the mid 1990s while the dollar value of sales increased. Computer technology played an increasing role among dental laboratories, from the standpoint of both research and business management. Advances in computer technology weeded out businesses that were unable to keep up, and may have accounted for the decline in the number of employees. But technological advances also accounted for the rise in sales and profitability for businesses on the leading technological edge.

Organization and Structure

About half of all individual dental laboratories are owned by corporate bodies, while the balance are owned and operated through sole proprietorship and partnerships. The Census figure of nearly $3 billion in revenues for 1997 agrees with data from economic conditions surveys sponsored by the National Association of Dental Laboratories. According to the survey, "dental laboratory sales represented only about two-tenths of a percent of the nation's total expenditures on health care" for 1994. The survey also indicated that 77.4 percent of dental labs with sales of no more than $50,000 were sole proprietorships; conversely, 82.3 percent of dental labs with sales volumes exceeding $1 million were owned by "regular corporations." National Dented Corporation, considered the largest operator of dental laboratories in the United States, experienced sales of over $44 million for fiscal 1995 alone, while Senate Corporation—the second largest owner of dental laboratories domestically —posted sales of $43 million for the same year.

Most of the country's dental laboratories are found in large metropolitan areas. Dental laboratories are spread throughout the United States; in 1997, each state contained at least 34 establishments. California was the leader, containing almost twice as many labs as any other state. With about 1,100 laboratories in 1997, California employed a work force of 6,000 people in this industry, and accounted for over $400 million of the industry's sales. Ranking directly behind California were Florida, with over 600 establishments, and New York, with almost 500.

Customarily, in creating an actual dental prosthesis (for example, full or partial dentures, a bridge, or a crown), laboratories follow instructions provided by the individual dentist and use a wax or plastic impression of the patient's mouth that had been made in the dentist's office. In some cases, dental laboratory technicians work directly for dentists and are present in the dental office setting itself to facilitate such procedures. Dental laboratory technicians working in actual laboratories may also have contact with patients in preparing and fitting the individual prostheses, but more commonly have no contact with patients at all. Dental laboratories typically purchase their materials from companies that manufactured products specifically for the health care industry (see SIC 3843, Dental Equipment Manufacturers ).

By the mid 1990s, dental laboratories were expected to comply with certain standards as set forth by the federal Occupational Safety and Health Administration (OSHA) and were subject to inspection by that body. According to the National Association of Dental Laboratories in 1996, a relatively small percentage of laboratories was actually inspected by the OSHA and the manner in which OSHA standards were applied to the industry's specific procedures and instruments was considered problematic due to inconsistency.

Qualifying dental laboratories were eligible to apply for certification from the National Board for Certification of Dental Laboratories (CDL), which had established specific standards for "personnel skills, laboratory facilities, and infection control in dental laboratories." According to the CDL, certification was potentially "invaluable in establishing credibility with outside third parties, including courts of law, insurance companies, and government." To receive certification, a laboratory is required to employ certified dental technicians in supervisory positions, document facility compliance with accepted health and safety standards, and maintain high levels of training and practice in infection control.

Background and Development

Restorative dentistry, as outlined by Bonnie L. Kendall in Opportunities in Dental Care, traced its beginnings to the Etruscan people of central Italy, who made bridges and crowns. In the Roman Empire, numerous processes were developed for the restoration of teeth by artificial means. Few dental advances were made in the Middle Ages, when the main antidote to toothache was extraction of the offending tooth. It was not until at least the sixteenth century that anatomical study led to new discoveries about teeth.

Restorative dentistry in the American colonies consisted of tooth transplants, false teeth, and a hygienic dentifrice. Such items were generally fashioned by the same individuals who treated toothaches. As the population of the United States grew, "dentists" began to establish permanent rather than itinerant practices. According to Kendall, silversmiths and goldsmiths periodically assisted in the creation of artificial teeth, working either independently or with dentists. By the nineteenth century, the majority of dentists made such prostheses themselves or employed apprentices to assist in their production. With the 1840 opening of America's first dental college in Baltimore, students began to receive training not only in dental procedures but also in the preparation and setting of artificial teeth; nationally, by 1986, there were 58 accredited training programs for the education of dental lab technicians. The precise date when independent laboratories first appeared is not known; by 1920, approximately 2,000 laboratories were in operation in the United States.

In 1933, according to Kendall, the government ruled that the dental laboratory industry should be operated by "a code of fair practices," and a group was established to formulate these guidelines. In 1951, the American Dental Laboratory merged with the Dental Laboratory Institute to form the National Association of Dental Laboratories (NADL). In 1952, the NADL opened its offices in Washington, D.C., and by 1958 had set up its Certified Dental Technician (CDT) program. The NADL's voluntary national program for laboratory certification (the National Board for Certification of Dental Laboratories) was instituted in 1977.

One of the most significant developments in the course of the dental laboratory industry's existence, aside from a gradual movement toward an increased emphasis on dental care, was the utilization of orthodontic appliances in a widespread fashion. Attributable in part to the growing affluence of the nation as a whole during the 1960s, this increase in use was also a result of technological advances made in the same decade. Prior to that period, in an era when only the most financially secure could afford orthodontia, dental surgeons had to adhere each metal band to individual teeth, one at a time, pinching the band around a tooth, then soldering it permanently in place—an arduous and time-consuming task. By the 1960s, however, significant advances had been achieved in the manufacture of metal braces, taking orthodontics into mass-production and eliminating the need for the piecemeal application of braces.

With these developments, the number of patients opting for orthodontia increased, eventually creating one of the primary market segments that would support dental laboratories in years to follow.

In the mid 1990s, health-related issues were of particular importance to the dental laboratory industry as a whole. Topics of concern included such items as infection control guidelines, occupational risk of exposure to HIV and other blood-borne diseases, and occupational lung diseases. There was a significant increase among all areas of dentistry in the hygienic precautions regularly taken to reduce the risk of exposure to blood.

Infection control guidelines from the U.S. Centers for Disease Control and Prevention applied not only to workers in dental offices, but to employees in dental laboratories as well. Occupational lung diseases, caused by exposure to a variety of dusts, also presented a risk to dental technicians, according to Infection Control Weekly. According to a study by French researcher D. Choudat, several respiratory and non-respiratory ailments were identified as being possibly related to the inhalation of dusts present in dental laboratories, specifically silica, alloys, and acrylic plastics. Although this was more of a concern in small independent labs than in large establishments, and more of a problem abroad than domestically, dental laboratories were encouraged to install and maintain adequate ventilation systems to reduce potential exposures for all employees. Choudat noted that these risks appeared cumulative, manifesting themselves to a greater degree and at a higher incidence among employees who had worked in dental laboratories for many years. Additionally, employees who smoked were considered at greater risk of contracting these occupational illnesses.

Current Conditions

The dental laboratory industry makes about three-fourths of its income from the production of artificial teeth, dentures, and other orthodontic appliances specifically based on prescriptions and orders from dentists. Laboratories provide record-keeping services that account for the remainder of its income. The industry's finished products add over $2 billion to the materials, energy, and other consumables used in manufacture.

Industry Leaders

According to revenue figures posted by the individual companies, the following companies lead the dental laboratory industry: National Dentex Corp. of Wayland, Massachusetts, with sales exceeding $63.8 million in 1998, 1,211 employees, and a dollar value in sales per employee of $52,684; Recigno Laboratories, Inc., of Willow Grove, Pennsylvania, with sales of $39 million in 1995, 500 employees, and sales per employee of $78,000 for 1995; Sentage Corp., with sales of $43 million, and 1,000 employees; James R. Glidewell Dental Ceramics, with sales of $26.5 million, and 400 employees; Americus Dental Labs LP, with sales of $14 million, and 200 employees; Dentalcare Partners Inc., with sales of $12 million, and 125 employees; and Dental Arts Laboratory Inc., with sales of $10.4 million, and 250 employees. As of 1996, National Dentex served an active customer base of 8,000 dentists via 24 full-service and five branch dental labs in 20 states and offered a full range of dental prostheses.

Workforce

The industry employed about 41,000 people in the late 1990s, down from roughly 44,000 people in the mid 1990s and from 49,000 in the early 1980s. Employment opportunities were expected to remain fair through the year 2005, according to Career Information Center. According to the 1997 Census, over 6,000 labs employed less than 10 people. Only the four largest labs employed more than 250 people.

The formal training of many dental laboratory technicians may begin as early as high school, through specific vocational courses, or via apprenticeship. Trainees normally work under the guidance of experienced practicing technicians, and generally gain skills over a period of at least three years. Individual technicians seeking to gain professional credentials as a Certified Dental Technician apply to the NADL's appropriate governing board for certification.

According to the U.S. Department of Labor, dental lab technicians, in the course of their daily work, may engage in the following sorts of tasks: employing a variety of hand tools for extremely detailed work; reading dentists' prescriptions and examining dental impressions and models; displaying expertise in grinding, polishing, and soldering of dental appliances; attempting to resolve problems in the design and setup of dentures; consulting with individual dentists for problem resolution, when necessary; and fabricating full or partial dentures and crowns.

Trainees in dental laboratories, according to the 1995 NADL survey, may have earned between $5.50 and $7.00 per hour to start. Wages for technicians with at least 10 years of experience earned at least $12 an hour, with $19 capping the hourly range.

Research and Technology

As one example of technological advances in the field, in 1995, Dr. Anthony Chillura wrote in Newsweek magazine that "technological breakthroughs promise to revolutionize the way … crowns … are created and fitted." Chillura noted that crown production in the past was a "time consuming multi-step process that began with alginate impressions of the tooth and continued through fabrication in a dental laboratory and subsequent fitting (and adjustment) to the patient in the chair." Using the new computerized crown manufacturing machine "the prototype system rapidly scans the tooth image and then computer-guided cutting hardware creates the crown." Gold or porcelain crowns that once took hours to prepare could henceforth be fashioned in about half an hour.

According to Business Wire in November 1996, Automated Products Incorporated (API), a Texas-based developer of such technology, indicated that by using this type of system one technician could "produce up to one hundred or more crown copings per day." Planned enhancements to API's system were expected to include "the ability to produce multi-unit bridges, inlays, onlays and laminates."

Further Reading

Business Wire, November 1996.

Career Information Center. 6th ed. Indianapolis, IN: Macmillan Library Reference USA, 1996.

Chillura, Anthony E. "High-Tech Dentistry." Newsweek, 23 October 1995.

Journal of Dental Technology, December 1996.

Macht, Joshua. "Together at Last: Communications." Inc. , 19 March 1996.

"Occupational Risk: Occupational Exposures Among Dental Workers." AIDS Weekly, 30 October 1995.

Report on the NADL 1995 Economic Conditions Survey of the Commercial Dental Laboratory Industry. Alexandria, VA: National Association of Dental Laboratories, 1995. Available from http://www.nadl.org .

U.S. Census Bureau. "Dental Laboratories." 1997 Economic Census: Manufacturing Industry Series. July 1999.



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